[Non-small cell lung cancer (NSCLC) stage IIIA/IIIB. A pilot study of neoadjuvant chemotherapy with paclitaxel and...

There is evidence that neoadjuvant chemotherapy may improve treatment results in patients with locally advanced NSCLC. The aim of the present study was to increase resectability rates by induction chemotherapy in NSCLC stage IIIA/IIIB with the new cytostatic combination, paclitaxel and carboplatin. Neoadjuvant treatment consisted of 3 cycles (q21) of chemotherapy with paclitaxel (200 mg/m(2)) and carboplatin (AUC 6). Seven patients with IIIA (T3N2, N-stage confirmed by mediastinoscopy) and 16 patients with IIIB (T4N0-2) entered the study. The response to chemotherapy was as follows: IIIA: 3x partial remission (PR), 2x no change (NC), 2x progressive disease (PD); IIIB: 5x PR, 4x NC, 7x PD. Five patients (71%) with IIIA and 8 patients (50%) with IIIB underwent thoracotomy with complete (R0) tumor resection. In all cases, the pT-stage was lower than the pretherapeutic T-stage. The most relevant adverse effect of chemotherapy was leukopenia WHO-grade 1-2. These data suggest that in many patients with T3N2 and in some patients with primarily unresectable T4N0-2 a neoadjuvant chemotherapy with paclitaxel and carboplatin leads to high response rates allowing a high complete resection rate.