Neoadjuvant Concurrent Radiochemotherapy in Locally Advanced (IIIa-IIIb) Non-Small Cell Lung Cancer: long term results according to downstaging.

Stefano Margaritora, Vincenzo Valentini, Giuseppe Maria Corbo, Venanzio Porziella, Lucio Trodella, Pierluigi Granone, Salvatore Valente, Giuseppe Macis, Alfredo Cesario, Rolando Maria D'Angelillo, Sara Ramella, Marzia Ciresa, Bruno Vincenzi, Numa Cellini, G. Tonini, B. Vincenzi

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

BACKGROUND: To report the efficacy of induction treatment (IT) protocol with concurrent radiochemotherapy in locally advanced non-small-cell lung cancer (NSCLC), and to analyze downstaging as a surrogate end point. PATIENTS AND METHODS: Patients with histo- or cytologically confirmed stage IIIA or IIIB NSCLC were treated according to an IT protocol followed by surgery. Downstaging was assessed for all resected patients. RESULTS: In the period between February 1992 and July 2000, 92 patients were enrolled in the study (57 IIIA, 35 IIIB). Response was observed in 63 patients; 56 patients underwent radical resection. Patients downstaged to stage 0-I (DS 0-I) showed a statistically significant improved disease-free survival (26.2 months pStage 0-I versus 11.2 months pStage II-III; P=0.0116) and overall survival (median 32.5 months pStage 0-I versus 18.3 months pStage II-III; P=0.025). Patients with DS 0-I had a significantly lower probability (P=0.0353) of developing distant metastases estimated in 0.2963 odds ratio. CONCLUSION: Neoadjuvant radiochemotherapy is feasible with good pathological DS results. Pathological downstaging was confirmed to have high predictive value. Its use is suggested in the short-term evaluation of induction protocols efficacy in locally advanced NSCLC.
Original languageEnglish
Pages (from-to)389-398
Number of pages10
JournalAnnals of Oncology
Publication statusPublished - 2004

Keywords

  • lung cancer
  • neoadjuvant

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