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Induction concurrent chemoradiation therapy for invading apical non-small cell lung cancer
Shinichiro Miyoshi1, Keiji Iuchi, Kenji Nakamura
1Division of Thoracic Surgery, Department of Surgery (E1), Osaka University Graduate School of Medicine, Osaka, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|April 14, 2004
Summary
Induction chemoradiation therapy (CRT) significantly improves survival for non-small cell lung cancer (NSCLC) invading the chest apex. This approach offers better outcomes than surgery alone or radiation therapy (RT) for this challenging NSCLC.
Area of Science:
- Thoracic Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Non-small cell lung cancer (NSCLC) invading the superior sulcus presents challenges with local recurrence after standard treatment.
- Current treatment often involves radiation therapy (RT) followed by surgery, but recurrence remains a significant issue.
- Investigating novel induction therapies is crucial for improving surgical outcomes in these patients.
Purpose of the Study:
- To evaluate the impact of induction therapy, specifically concurrent chemoradiation therapy (CRT), on surgical results for NSCLC invading the chest apex.
- To compare the efficacy of induction CRT versus induction RT or surgery alone in improving survival rates.
Main Methods:
- Retrospective review of 30 patients with NSCLC invading the chest apex who underwent surgery between 1987 and 1996.
- Patient groups included surgery alone (10), RT followed by surgery (9), and induction CRT followed by surgery (11).
- Chemotherapy regimen included cisplatin-based agents concurrently with RT.
Main Results:
- Four-year survival rates were 20% for surgery alone, 11% for induction RT, and 53% for induction CRT.
- Induction CRT demonstrated significantly better survival compared to induction RT or surgery alone.
- Univariate and multivariate analyses identified induction therapy (CRT) as a significant positive prognostic factor for survival.
Conclusions:
- Induction concurrent chemoradiation therapy (CRT) appears to enhance survival outcomes for patients with NSCLC invading the apex of the chest wall.
- The findings suggest that induction CRT is a superior treatment strategy compared to induction RT or surgery alone for this specific NSCLC subtype.
- Further prospective studies are warranted to confirm these promising results.