A retrospective study: platinum-based induction chemotherapy combined with gemcitabine or paclitaxel for stage IIB-IIIA
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
A retrospective study: platinum-based induction chemotherapy combined with gemcitabine or paclitaxel for stage IIB-IIIA central non-small-cell lung cancer Chao Lv1, Yuanyuan Ma1, Nan Wu1, Shi Yan1, Qingfeng Zheng1, Yu Sun2, Shaolei Li1, Jian Fang3 and Yue Yang1*
Abstract Background: Several encouraging phase III clinical trials have evaluated platinum-based induction chemotherapy against stage IIB-IIIA non-small-cell lung cancer (NSCLC). Chemotherapy efficacy was assessed using common regimens in this retrospective analysis. Methods: From 2007 to 2011, the clinical records of stage IIB-IIIA NSCLC patients undergoing surgery after neoadjuvant chemotherapy were reviewed. Gathered data were tested for significance and variables impacting survival were assessed by univariate and Cox regression analyses. Results: Overall, 84% of patients were male and 93% had central disease. Platinum-based chemotherapy protocols with gemcitabine or paclitaxel gave an overall response rate of 55% (45/82) and 6.1% pathological complete response (5/82). Clinical response was unassociated with regimen or histology, while more pneumonectomies were performed in the stable compared to partial response disease group (P =0.040). Postoperative mortality was 1.2% (1/82), and complications, unassociated with regimen or histology, were atelectasis (26.8%) and supraventricular arrhythmias (13.4%). Right-sided procedures appeared to increase the incidence of bronchopleural fistula (P =0.073). The median disease-free survival time was 18 months and median overall survival time was not reached. Disease-free survival rates at one, two, and three years were 54%, 47%, and 33%, while the overall survival rate was 73%, 69%, and 59%, respectively. Disease-free survival predictors were radiographic response and mediastinal lymphadenopathy before chemotherapy (P =0.012 and 0.002, respectively). Conclusions: Two cycles of platinum-based chemotherapy with gemcitabine or paclitaxel is efficacious for patients with stage IIB-IIIA central disease. Patients achieving clinical response had improved disease-free survival times, while those with mediastinal lymphadenopathy had a higher postoperative recurrence risk. Keywords: Non-small-cell lung cancer, Induction chemotherapy, Central disease, Resection, Squamous
Background Lung cancer in stage IIB-IIIA generally has an unfavorable prognosis, with poor five-year survival rates ranging from 19 to 25% for those using clinical stage prediction and 24 to 36% for those using pathological stage prediction, respectively [1]. Complete surgical resection has a * Correspondence: [email protected] 1 Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Peking, China Full list of author information is available at the end of the article
low survival and high recurrence rate, although effective systemic therapies, including perioperative chemotherapy, radi
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