Effectiveness of Neoadjuvant Therapies in Early-Stage Non-Small Cell Lung Cancer: Single Center Experience

Öz

We aimed to evaluate the effectiveness of neoadjuvant therapies in early-stage non-small cell lung cancer (NSCLC) patients followed at our clinic between 2016 and 2023. A retrospective review was conducted on the records of early-stage NSCLC patients treated at İstanbul Medipol University School of Medicine, Department of Medical Oncology. Patients receiving neoadjuvant chemotherapy, chemoimmunotherapy, or chemoradiotherapy followed by surgery were included. Clinical and pathological characteristics were documented, including age, gender, smoking history, ECOG performance status, clinical and pathological staging, histological type, use of neoadjuvant immunotherapy or radiotherapy, and PD-L1 levels. The relationship between clinical-pathological factors and pathological complete response (pCR) was analyzed. Seventeen patients with a median age of 64 (range: 51-71) were included. The pCR rate was 29.4%. The 24-month disease-free survival rate was 85.7%, with no disease-related deaths reported. Concurrent radiotherapy was significantly associated with higher pCR rates. Other clinical-pathological factors did not show statistically significant differences between pCR and non-pCR groups. Neoadjuvant therapies, including chemotherapy, chemoimmunotherapy, and chemoradiotherapy, are effective in early-stage NSCLC, demonstrated by high pCR and disease-free survival rates. Concurrent radiotherapy may enhance treatment efficacy and warrants further investigation. These findings support the use of neoadjuvant approaches in managing early-stage NSCLC.

Anahtar Kelimeler

• lung cancer
• neoadjuvant therapy
• immunotherapy

Erken Evre Küçük Hücreli Dışı Akciğer Kanserinde Neoadjuvan Tedavilerin Etkinliği: Tek Merkez Deneyimi

Öz

Kliniğimizde 2016-2023 yılları arasında takip edilen erken evre küçük hücreli dışı akciğer kanseri (KHDAK) hastalarında neoadjuvan tedavilerin etkinliğini değerlendirmeyi amaçladık. İstanbul Medipol Üniversitesi Tıp Fakültesi Tıbbi Onkoloji kliniğinde tedavi gören erken evre KHDAK hastalarının kayıtları retrospektif olarak incelendi. Neoadjuvan kemoterapi, kemoimmünoterapi veya kemoradyoterapi sonrası opere edilen hastalar çalışmaya dahil edildi. Yaş, cinsiyet, sigara öyküsü, ECOG performans skoru, klinik ve patolojik evre, histolojik tip, neoadjuvan immünoterapi veya radyoterapi kullanımı ve PD-L1 düzeyleri gibi klinikopatolojik özellikler kaydedildi. Klinikopatolojik faktörler ile patolojik tam yanıt (pCR) arasındaki ilişki analiz edildi. Yaş ortalaması 64 (aralık: 51-71) olan on yedi hasta dahil edildi. Patolojik tam yanıt oranı %29.4 olarak bulundu. 24 aylık hastalıksız sağkalım oranı %85.7 idi ve hastalık ilişkili ölüm bildirilmedi. Eş zamanlı radyoterapi, daha yüksek pCR oranları ile anlamlı olarak ilişkili bulundu. Diğer klinikopatolojik faktörler arasında istatistiksel olarak anlamlı fark saptanmadı. Neoadjuvan kemoterapi, kemoimmünoterapi ve kemoradyoterapi, erken evre KHDAK'de yüksek pCR ve hastalıksız sağkalım oranları ile etkili tedavi seçenekleridir. Eş zamanlı radyoterapi tedavi etkinliğini artırabilir ve daha fazla araştırılmalıdır. Bu bulgular, erken evre KHDAK tedavisinde neoadjuvan yaklaşımların önemini desteklemektedir.

Anahtar Kelimeler

• akciğer kanseri
• neoadjuvan tedavi
• immünoterapi

Kaynakça

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