Your browser doesn't support javascript.
loading
Neoadjuvant chemoradiation and surgery improves survival outcomes compared with definitive chemoradiation in the treatment of stage IIIA N2 non-small-cell lung cancer.
Darling, Gail E; Li, Fei; Patsios, Demetris; Massey, Christine; Wallis, Adam G; Coate, Linda; Keshavjee, Shaf; Pierre, Andrew; De Perrot, Marc; Yasufuku, Kazuhiro; Cypel, Marcelo; Waddell, Tom.
Afiliación
  • Darling GE; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada gail.darling@uhn.ca.
  • Li F; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Patsios D; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Massey C; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Wallis AG; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Coate L; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Keshavjee S; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Pierre A; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • De Perrot M; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Yasufuku K; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Cypel M; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
  • Waddell T; Toronto General Hospital, University Health Network Toronto, Toronto, ON, Canada.
Eur J Cardiothorac Surg ; 48(5): 684-90; discussion 690, 2015 Nov.
Article en En | MEDLINE | ID: mdl-25567960
OBJECTIVES: The objective of this study was to compare survival in patients with stage IIIA (N2) non-small-cell lung cancer (NSCLC) treated with definitive chemoradiation (CRT) or surgery plus neoadjuvant chemoradiation or chemotherapy (CRTS). METHODS: A retrospective analysis of 242 patients with stage IIIA (N2) NSCLC treated with curative intent between 1997 and 2007, identified 215 patients with surgically resectable disease. Overall survival outcomes were analysed using the Kaplan-Meier plots, log-rank tests and Cox proportional hazards models adjusting for age, gender, histology, smoking history and performance status. Recurrences were compared using competing risks methods, including the proportional subdistribution hazards regression model. RESULTS: CRTS was used to treat 104 patients and CRT in 111. Comparing CRTS with CRT patients, median age was 60 vs 62, 50 (48%) vs 69 (62%) were male and 65 (62.5%) vs 60 (54%) had adenocarcinoma. Of CRTS patients, 83 (80%) had a lobectomy. CRTS patients compared with CRT patients had decreased risk of recurrence at any site [hazard ratio (HR) = 0. 46, 95% confidence interval (CI): 0.32-0.64 P < 0.0001], local recurrence (HR = 0.50, 95% CI: 0.29-0.87, P = 0.013), loco--regional recurrence (HR = 0.51, 95% CI: 0.33-0.78, P = 0.002) and death (HR: 0.45, 95% CI: 0.33-0.62, P < 0.0001) with a median survival of 4.2 years vs 1.7 years). Risk of distant recurrence was also reduced in the surgical group (HR: 0.57; 95% CI: 0.38-0.87, P = 0.017). Treatment-related mortality was low in both cohorts. CONCLUSION: For patients with surgically resectable stage IIIA (N2) NSCLC, neoadjuvant therapy plus surgery reduces loco-regional and distant recurrence and improves survival. Treatment-related mortality was not significantly increased compared with the patients treated with CRT alone.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Terapia Neoadyuvante / Quimioradioterapia / Neoplasias Pulmonares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Terapia Neoadyuvante / Quimioradioterapia / Neoplasias Pulmonares Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Alemania