1. Preoperative concurrent radiation therapy and cisplatinum continuous infusion in IIIa (N2) non small cell lung cancer. A pilot study.
- Author
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Maggi G, Casadio C, Cianci R, Oliaro A, Molinatti M, Bretti S, Clerico M, Boidi-Trotti A, and Rovea P
- Subjects
- Actuarial Analysis, Adenocarcinoma mortality, Adenocarcinoma pathology, Adult, Carcinoma, Large Cell mortality, Carcinoma, Large Cell pathology, Carcinoma, Non-Small-Cell Lung mortality, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Combined Modality Therapy, Female, Humans, Infusions, Intravenous, Lung Neoplasms mortality, Lung Neoplasms pathology, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Pilot Projects, Prognosis, Radiotherapy Dosage, Survival Rate, Thoracotomy, Adenocarcinoma drug therapy, Adenocarcinoma radiotherapy, Carcinoma, Large Cell drug therapy, Carcinoma, Large Cell radiotherapy, Carcinoma, Non-Small-Cell Lung drug therapy, Carcinoma, Non-Small-Cell Lung radiotherapy, Carcinoma, Squamous Cell drug therapy, Carcinoma, Squamous Cell radiotherapy, Cisplatin therapeutic use, Lung Neoplasms drug therapy, Lung Neoplasms radiotherapy, Preoperative Care methods
- Abstract
From April 1991 to September 1993, 18 patients affected by a presumed operable IIIa (N2) non small cell lung cancer (NSCLC) with histologically confirmed bulky mediastinal metastases, received preoperative concurrent radiation therapy and continuous infusion of cisplatinum (CDDP). The radiotherapy consisted of 2 Gy given 5 days a week for a total dose of 50 Gy; CDDP was administered by means of a central catheter and a portable pump at the daily dose of 6 mg/m2 given on the same days as the radiation therapy (total dose: 150 mg/m2). Two weeks after the end of the treatment, the patients were reevaluated: 5 patients had either local or distant disease progression, the other 13 were submitted to thoracotomy: 12 received a complete resection and 1 patient underwent only a mediastinal lymphadenectomy, because pneumonectomy was impossible due to lack of respiratory function. No histological evidence of cancer cells was observed in the specimens of 6 patients (33%). Radiological response rate was 61% (11/18); resection rate was 66% (12/18) and complete resection rate was 61% (11/18). There was one postoperative death (5%). The 3 year actuarial survival rate is 63.6% for the patients who received a resection with a median survival time of 18 months. All non operated patients died within one year. Combined preoperative treatment was well tolerated. Better results were achieved in patients with squamous cell carcinoma who had a complete resection following a total tumor sterilization with radio-chemotherapy.
- Published
- 1994