[Estimation of preoperative induction chemoradiotherapy effectiveness for non small-cell lung cancer]

We have performed the clinical evaluations of preoperative induction chemoradiotherapy (CRTx) for 25 patients with non small-cell lung cancer (male: 19, female: 6, mean age: 66.4-year-old). The clinical stages of these patients were IIA: 1, IIB: 7, IIIA: 14, and IIIB: 3, respectively. In the histological type of lung cancer, there were 12 patients of adenocarcinoma, 7 of squamous cell carcinoma, 1 of adenosquamous carcinoma, 1 of anaplastic carcinoma, and 4 of large cell carcinoma. We applied two courses of regimen as the pre-operative chemotherapy (CDDP+DOC or CBDCA+PTX). Twenty-four patients received radiotherapy as the concurrent radiotherapy (44 Gy: 22 patients, 60 Gy: 2 patients). Among the 25 patients, 16 patients accomplished both chemotherapies, and the effects of the treatment were as follows: CR; none, PR; 15, SD; 9, respectively. And the other patient was not an evaluable case due to atelectasis. Histopathological effects (Ef) were Ef-3: 3, Ef-2: 11, Ef-1: 7, Ef-0: 1 and Ef was not evaluable in 3 cases. Post operative pathological findings showed that 14 patients were down staged. There were no operative mortality associated with the operation, and no serious morbidity case was observed. Eighteen patients were survived and 1 patient was survived with tumor metastases. Only one patient died of recurrence in the upper mediastinal lymph nodes, 3 patients died of the brain metastases, one died of hepatic metastasis, and one died of cryptogenic sudden death. As a result, there was no serious operative morbidity observed in the course of this CRTx. We therefore recommend that induction chemoradiotherapy as a beneficial pre-operative treatment.