Koji Kawaguchi1, Kohei Yokoi2, Hiroshi Niwa3, Yasuhisa Ohde4, Shoichi Mori5, Sakae Okumura6, Satoshi Shiono7, Hiroyuki Ito8, Motoki Yano9, Kikuo Shigemitsu10, Yoshinori Hiramatsu11, Jiro Okami12, Hideo Saka13. 1. Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 2. Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: k-yokoi@med.nagoya-u.ac.jp. 3. Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan. 4. Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. 5. Department of Thoracic Surgery, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan. 6. Department of Thoracic Surgical Oncology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan. 7. Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. 8. Division of Thoracic Surgery, Thoracic Oncology, and Pathology, Kanagawa Cancer Center, Yokohama, Japan. 9. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 10. Department of Thoracic Surgery, Ogaki Municipal Hospital, Ogaki, Japan. 11. Department of Thoracic Surgery, Toyota Kosei Hospital, Toyota, Japan. 12. Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 13. Departments of Respiratory Medicine and Medical Oncology, Nagoya Medical Center, Nagoya, Japan.
Abstract
OBJECTIVES: The standard therapy for patients with T3N0-1M0 non-small cell lung cancer (NSCLC) involving the chest wall is considered surgical resection and adjuvant therapy. However, the compliance of adjuvant therapy is relatively low, and the prognosis for those patients has been unsatisfactory. Therefore, we conducted a phase II study of induction chemoradiotherapy followed by surgery with the aim of improving the survival. PATIENTS AND METHODS: This treatment strategy consisted of induction chemotherapy (two cycles of cisplatin at 80mg/m2 on Day 1 and vinorelbine at 20mg/m2 on Days 1 and 8) concurrent with radiotherapy (40Gy in 20 fractions) followed by surgery. The inclusion criteria were patients with resectable T3N0-1M0 NSCLC involving the chest wall who were 20-70 years of age. The primary end point was the 3-year survival, assuming an expected rate of 67%. RESULTS: From January 2009 to November 2012, 51 eligible patients were enrolled. Induction therapy was completed as planned in 49 (96%) patients without treatment-related death, and 25 (51%) had a partial response. Complete resection combined with the involved chest wall was achieved in 46 (92%) patients, and a pathologic complete response was seen in 13 (26%) patients. Five patients experienced major postoperative complications, and 1 patient died of acute exacerbation of interstitial pneumonia. With a median follow-up period of 42 months, the 3- and 5-year overall survivals of all registered patients were 77% and 63%, respectively. There was a significant difference in the survival rate between patients with a pathologic complete response and those with a residual tumor (p=0.039). CONCLUSION: The mature results of this study in a multi-institutional setting showed the treatment strategy to be safe and effective with a high rate of pathologic response for patients with NSCLC involving the chest wall. Copyright Â
OBJECTIVES: The standard therapy for patients with T3N0-1M0 non-small cell lung cancer (NSCLC) involving the chest wall is considered surgical resection and adjuvant therapy. However, the compliance of adjuvant therapy is relatively low, and the prognosis for those patients has been unsatisfactory. Therefore, we conducted a phase II study of induction chemoradiotherapy followed by surgery with the aim of improving the survival. PATIENTS AND METHODS: This treatment strategy consisted of induction chemotherapy (two cycles of cisplatin at 80mg/m2 on Day 1 and vinorelbine at 20mg/m2 on Days 1 and 8) concurrent with radiotherapy (40Gy in 20 fractions) followed by surgery. The inclusion criteria were patients with resectable T3N0-1M0 NSCLC involving the chest wall who were 20-70 years of age. The primary end point was the 3-year survival, assuming an expected rate of 67%. RESULTS: From January 2009 to November 2012, 51 eligible patients were enrolled. Induction therapy was completed as planned in 49 (96%) patients without treatment-related death, and 25 (51%) had a partial response. Complete resection combined with the involved chest wall was achieved in 46 (92%) patients, and a pathologic complete response was seen in 13 (26%) patients. Five patients experienced major postoperative complications, and 1 patient died of acute exacerbation of interstitial pneumonia. With a median follow-up period of 42 months, the 3- and 5-year overall survivals of all registered patients were 77% and 63%, respectively. There was a significant difference in the survival rate between patients with a pathologic complete response and those with a residual tumor (p=0.039). CONCLUSION: The mature results of this study in a multi-institutional setting showed the treatment strategy to be safe and effective with a high rate of pathologic response for patients with NSCLC involving the chest wall. Copyright Â
Authors: Gregory D Jones; Raul Caso; Jae Seong No; Kay See Tan; Joseph Dycoco; Manjit S Bains; Valerie W Rusch; James Huang; James M Isbell; Daniela Molena; Bernard J Park; David R Jones; Gaetano Rocco Journal: Eur J Cardiothorac Surg Date: 2020-07-01 Impact factor: 4.191
Authors: Terrance Peng; Sean C Wightman; Li Ding; Scott M Atay; Evan T Alicuben; Elizabeth A David; Anthony W Kim Journal: JTO Clin Res Rep Date: 2021-05-18