A retrospective study: platinum-based induction chemotherapy combined with gemcitabine or paclitaxel for stage IIB-IIIA central non-small-cell lung cancer

World Journal of Surgical Oncology

Yue Yang²  Jian Fang¹  Shaolei Li²  Yu Sun³  Qingfeng Zheng²  Shi Yan²  Nan Wu²  Yuanyuan Ma²  Chao Lv² 

[1]Department of Thoracic Medical Oncology II, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Peking University Cancer Hospital & Institute, Peking, China

[2]Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Peking, China

[3]Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Peking, China

关键词: Squamous;    Resection;    Central disease;    Induction chemotherapy;    Non-small-cell lung cancer;   

Others  :  825769
DOI  :  10.1186/1477-7819-11-76

 received in 2012-10-23, accepted in 2013-02-23,  发布年份 2013

【 摘 要 】

Background

Several encouraging phase III clinical trials have evaluated platinum-based induction chemotherapy against stage IIB-IIIA non-small-cell lung cancer (NSCLC). Chemotherapy efficacy was assessed using common regimens in this retrospective analysis.

Methods

From 2007 to 2011, the clinical records of stage IIB-IIIA NSCLC patients undergoing surgery after neoadjuvant chemotherapy were reviewed. Gathered data were tested for significance and variables impacting survival were assessed by univariate and Cox regression analyses.

Results

Overall, 84% of patients were male and 93% had central disease. Platinum-based chemotherapy protocols with gemcitabine or paclitaxel gave an overall response rate of 55% (45/82) and 6.1% pathological complete response (5/82). Clinical response was unassociated with regimen or histology, while more pneumonectomies were performed in the stable compared to partial response disease group (P =0.040). Postoperative mortality was 1.2% (1/82), and complications, unassociated with regimen or histology, were atelectasis (26.8%) and supraventricular arrhythmias (13.4%). Right-sided procedures appeared to increase the incidence of bronchopleural fistula (P =0.073). The median disease-free survival time was 18 months and median overall survival time was not reached. Disease-free survival rates at one, two, and three years were 54%, 47%, and 33%, while the overall survival rate was 73%, 69%, and 59%, respectively. Disease-free survival predictors were radiographic response and mediastinal lymphadenopathy before chemotherapy (P =0.012 and 0.002, respectively).

Conclusions

Two cycles of platinum-based chemotherapy with gemcitabine or paclitaxel is efficacious for patients with stage IIB-IIIA central disease. Patients achieving clinical response had improved disease-free survival times, while those with mediastinal lymphadenopathy had a higher postoperative recurrence risk.

【 授权许可】

   
2013 Lv et al.; licensee BioMed Central Ltd.

【 图 表 】

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