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Preoperative chemotherapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer.

Publication ,  Journal Article
Higgins, K; Chino, JP; Marks, LB; Ready, N; D'Amico, TA; Clough, RW; Kelsey, CR
Published in: Int J Radiat Oncol Biol Phys
December 1, 2009

PURPOSE: To compare preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer. METHODS AND MATERIALS: This retrospective study analyzed all patients with pathologically confirmed Stage III (N2) non-small-cell lung cancer who initiated preoperative ChT or ChT-RT at Duke University between 1995 and 2006. Mediastinal pathologic complete response (pCR) rates were compared using a chi-square test. The actuarial overall survival, disease-free survival, and local control were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was also performed. RESULTS: A total of 101 patients who initiated preoperative therapy with planned resection were identified. The median follow-up was 20 months for all patients and 38 months for survivors. The mediastinal lymph nodes were reassessed after preoperative therapy in 88 patients (87%). Within this group, a mediastinal pCR was achieved in 35% after preoperative ChT vs. 65% after preoperative ChT-RT (p = 0.01). Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1). For all patients, the overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively. No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups. On multivariate analysis, a mediastinal pCR was associated with improved disease-free survival (p = 0.03) and local control (p = 0.03), but not overall survival (p = 0.86). CONCLUSION: Preoperative ChT-RT was associated with higher mediastinal pCR rates but not improved survival.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

December 1, 2009

Volume

75

Issue

5

Start / End Page

1462 / 1467

Location

United States

Related Subject Headings

  • Survival Analysis
  • Retrospective Studies
  • Remission Induction
  • Regression Analysis
  • Preoperative Period
  • Oncology & Carcinogenesis
  • North Carolina
  • Neoplasm Staging
  • Middle Aged
  • Mediastinum
 

Citation

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MLA
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Higgins, K., Chino, J. P., Marks, L. B., Ready, N., D’Amico, T. A., Clough, R. W., & Kelsey, C. R. (2009). Preoperative chemotherapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer. Int J Radiat Oncol Biol Phys, 75(5), 1462–1467. https://doi.org/10.1016/j.ijrobp.2009.01.069
Higgins, Kristin, Junzo P. Chino, Lawrence B. Marks, Neal Ready, Thomas A. D’Amico, Robert W. Clough, and Chris R. Kelsey. “Preoperative chemotherapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer.Int J Radiat Oncol Biol Phys 75, no. 5 (December 1, 2009): 1462–67. https://doi.org/10.1016/j.ijrobp.2009.01.069.
Higgins K, Chino JP, Marks LB, Ready N, D’Amico TA, Clough RW, et al. Preoperative chemotherapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1462–7.
Higgins, Kristin, et al. “Preoperative chemotherapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer.Int J Radiat Oncol Biol Phys, vol. 75, no. 5, Dec. 2009, pp. 1462–67. Pubmed, doi:10.1016/j.ijrobp.2009.01.069.
Higgins K, Chino JP, Marks LB, Ready N, D’Amico TA, Clough RW, Kelsey CR. Preoperative chemotherapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1462–1467.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

December 1, 2009

Volume

75

Issue

5

Start / End Page

1462 / 1467

Location

United States

Related Subject Headings

  • Survival Analysis
  • Retrospective Studies
  • Remission Induction
  • Regression Analysis
  • Preoperative Period
  • Oncology & Carcinogenesis
  • North Carolina
  • Neoplasm Staging
  • Middle Aged
  • Mediastinum