The Effect of Definitive Chemo / Radiotherapy on Surgery and Survival In Patients With Non-Small Cell Lung Cancer with A Single Mediastinal Metastasis (N2) Diagnosed

Abstract

Background: A combination of platinum-based chemotherapy and definitive radiotherapy is the standard of care for Stage III (N2) NSCLC patients who have single or multiple lymph node metastasis. However, lung resection could be performed in patients with residual disease without lymph node metastasis. Methods: Between January 2010 and December 2013 eligible patients had pathologically proven, stage IIIA/N2 non-small-cell lung cancer and were prospectively recorded. Those in the chemoradiotherapy group received three cycles of neoadjuvant chemotherapy (AUCx2 carboplatin and docetaxel 85 mg/m[2 ] docetaxel) and concurrent radiotherapy with 61.2 Gy in 34 fractions over 3 weeks followed by surgical resection. Also, a group of patients who had definitive chemoradiotherapy without chemoradiotherapy was compared with the surgical group. All patients in two groups were proven to have no N2 disease after chemoradiotherapy. Results: A total of 29 patients were enrolled, of whom 6 received chemoradiotherapy followed by surgical resection and 21 had chemoradiotherapy only.No patient died postoperatively.Two patients had severe toxicity. Median overall survival was 26.66 ± 4.35 and months) in the chemoradiotherapy + surgery group and 21.75 ± 4.82 months (4.0–38.6) in the chemoradiotherapy group (p=0, 275). Conclusion: Pulmonary resection after definitive chemoradiotherapy is safe and surgical resection after chemoradiotherapy may provide better survival in histologically proven N2 stage IIIA non-small cell lung cancer.

Keywords

• lung cancer
• definitive chemotherapy
• definitive radiotherapy

Tanı Konulmuş Tek Mediastinal Metastazı (N2) Olan Küçük Hücreli Dışı Akciğer Kanserli Hastalarda Definitif Kemo/Radyoterapi nin Cerrahi ve Sağkalıma Etkisi

Abstract

Giriş: Platin bazlı kemoterapi ve ful doz radyoterapinin kombinasyonu, tek veya çoklu lenf nodu metastazı olan Evre III (N2) KHDAK hastaları için standart tedavi yöntemidir. Bununla birlikte, lenf nodu ve uzak metastazı olmayan hastalarda akciğer rezeksiyonu yapılabilir. Yöntemler: Ocak 2010 ile Aralık 2013 arasında patolojik olarak kanıtlanmış, evre IIIA / N2 küçük hücreli dışı akciğer kanserili hastalar kaydedildi. Kemoradyoterapi grubundakiler üç döngü neoadjuvan kemoterapi (AUCx2 karboplatin ve dosetaksel 85 mg / m2 [2] dosetaksel) ve 3 hafta boyunca 34 fraksiyonda 61.2 Gy ile eşzamanlı radyoterapi ve ardından cerrahi rezeksiyon yapıldı. Ayrıca definitif kemoradyoterapi alan bir grup hasta cerrahi grupla karşılaştırıldı. İki gruptaki tüm hastaların kemoradyoterapi sonrası N2 hastalığı olmadığı kanıtlandı. Sonuçlar: Toplam 29 hasta kaydedildi, bunlardan 6'sı definitif kemoradyoterapi, ardından cerrahi rezeksiyon ve 21'i sadece kemoradyoterapi aldı, postoperatif hiçbir hasta ölmedi, iki hastada şiddetli toksisite vardı. Medyan genel sağkalım kemoradyoterapi + cerrahi grubunda 26.66 ± 4.35 ay) ve kemoradyoterapi grubunda 21.75 ± 4.82 ay (4.0-38.6) idi (p = 0, 275). Sonuç: Definitif kemoradyoterapi sonrası pulmoner rezeksiyon güvenlidir ve kemoradyoterapi sonrası cerrahi rezeksiyon, histolojik olarak kanıtlanmış N2 evre IIIA küçük hücreli dışı akciğer kanserinde daha iyi sağkalım sağlayabilir.

Keywords

• definitif kemoterapi
• akciğer kanseri
• definitif radyoterapi

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