1. 10-year long-term survival (LTS) of induction chemotherapy with three cycles cisplatin/paclitaxel followed by concurrent chemoradiation cisplatin/etoposide/45Gy (1.5Gy bid) plus surgery in locally advanced non-small-cell lung cancer (NSCLC)—A multicenter phase-II trial (CISTAXOL)
- Author
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Hepp de los Rios Rodrigo, Thomas Gauler, Stephan Bildat, Siegfried Seeber, B. Fischer, Georgios Stamatis, Thomas Krbek, Dirk Theegarten, C. Lepechoux, C. Poettgen, Martin Stuschke, Dominique Grunenwald, Thierry Le Chevalier, Wilfried Eberhardt, and Stefan Welter
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Paclitaxel ,Medizin ,non-small cell lung cancer (NSCLC) ,Kaplan-Meier Estimate ,chemistry.chemical_compound ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Medicine ,Prospective Studies ,Survivors ,Lung cancer ,Etoposide ,Aged ,Cisplatin ,business.industry ,Induction chemotherapy ,Chemoradiotherapy ,Induction Chemotherapy ,Middle Aged ,medicine.disease ,Surgery ,Regimen ,Treatment Outcome ,chemistry ,Female ,Histopathology ,business ,Follow-Up Studies ,medicine.drug - Abstract
Induction chemoradiotherapy plus surgery remains an option to study in IIIA(N2) and selected IIIB NSCLC. Here we report ten-year long-term survival of a prospective multicenter German-French phase-II trial with trimodality.Mediastinoscopically proven IIIA(N2)/selected IIIB NSCLC received three cycles cisplatin (50 mg/m(2) day 1+8) and paclitaxel (175 mg/m(2)d1) qd 22. Concurrent CTx/RTx followed: 45 Gy (1.5 Gy bid) with cisplatin 50 mg/m(2) day 2+9 and etoposide 100 mg/m(2) d 4-6. Surgery was planned three to five weeks after RTx. If evaluated inoperable/irresectable at the end of RTx, definitive RTx-boost (20 Gy; 2 Gy qd) followed. Here we report 10-year-LTS for this cohort.All 64 patients were accrued 3/99 to 2/02. Patients characteristics: IIIA(N2)/IIIB 25/39; m/f 48/16; adeno/squamous/large-cell/adenosquamous/NOS 15/26/18/3/2; age: median 52.5 (range 33-69). 36 operated: R0 32/36 (89%); pCR 16/36 (44%). 10-year-LTS%; all 26.0; IIIA(N2) 37.1; IIIB 17.9; relevant prognostic factors (exploratory): pretreatment - histopathology (squamous/adeno) - age (50/≥50) - Charlson-CI: 1/1 - BMI (≥25/25) - pack years smoking (≥10/10); treatment-dependent - R0/no-R0.This regimen achieves substantial LTS. Interestingly, adenocarcinomas, older patients, unfavorable comorbidity scores, higher BMI and light smokers demonstrate poor long-term outcome even with aggressive trimodality. This dataset defines the rationale for our ongoing randomized trial with surgery after induction therapy in IIIA(N2)/selected IIIB (ESPATÜ).
- Published
- 2013