Preoperative Chemotherapy vs. Chemoradiotherapy in Non-Small-Cell Lung Cancer: A Retrospective Study

Strategic Insights -

Scientists in the United States conducted a study comparing preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer patients. The retrospective study analyzed 101 patients who initiated preoperative therapy with planned resection at Duke University between 1995 and 2006. The researchers found that preoperative ChT-RT was associated with higher mediastinal pathologic complete response (pCR) rates, but not improved survival.

Key Takeaways:

  • The study compared preoperative chemotherapy (ChT) and preoperative chemoradiotherapy (ChT-RT) in operable Stage III non-small-cell lung cancer patients.
  • A total of 101 patients were identified who initiated preoperative therapy with planned resection at Duke University between 1995 and 2006.
  • The median follow-up was 20 months for all patients and 38 months for survivors.
  • Preoperative ChT-RT was associated with higher mediastinal pCR rates (65% vs. 35%, p = 0.01).
  • Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1).
  • No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups.
  • A mediastinal pCR was associated with improved disease-free survival (p = 0.03) and local control (p = 0.03), but not overall survival (p = 0.86).
  • The researchers concluded that preoperative ChT-RT was associated with higher mediastinal pCR rates, but not improved survival.

Statistics:

  • 101 patients were identified for the study.
  • The mediastinal pCR rates were 35% after preoperative ChT and 65% after preoperative ChT-RT (p = 0.01).
  • Resection was performed in 69% after ChT and 84% after ChT-RT (p = 0.1).
  • The overall survival, disease-free survival, and local control rate at 3 years was 40%, 27%, and 66%, respectively.
  • No statistically significant differences were found in the clinical endpoints between the ChT and ChT-RT subgroups.

Sources:

  • K. Higgins et al. "Preoperative chemotherapy versus preoperative chemoradiation therapy for stage III (N2) non-small-cell lung cancer." International Journal of Radiation Oncology Biology Physics 2009;75(5):1462-1467.
  • University Medical Center, Department of Radiation Oncology, Division of Medical Oncology, Duke University Medical Center, Durham, NC 27710, USA.
  • Elsevier Science Inc., 360 Park Avenue South, New York, NY 10010-1710, USA.