[Multimodality Therapy for Lung Cancer with Chest Wall Invasion]

The standard therapy for patients with T3N0-1M0 non-small cell lung cancer (NSCLC) involving the chest wall is considered initial resection and adjuvant chemotherapy. However, the compliance of adjuvant therapy is relatively low, and the prognosis for those patients has not been satisfactory. We therefore advocated a new strategy of induction chemoradiotherapy followed by surgery and conducted a prospective, multi-institutional phaseⅡ trial with the aim of improving the survival. The mature results of this trial showed the treatment strategy to be safe and effective with a high rate of pathologic response. We also reviewed surgical cases in our hospital retrospectively. Induction therapy was administered for a half of patients with NSCLC involving the chest wall, and a pathologic complete response (Ef.3) was obtained in 23% of those cases with an excellent prognosis. We therefore conclude that induction therapy, especially chemoradiotherapy, would increase the possibility of cure for NSCLC patients with chest wall invasion.