Title: Present status of induction treatment in stage IIIA-N2 non-small cell lung cancer: a review. The Leuven Lung Cancer Group
Authors: Vansteenkiste, Johan ×
De Leyn, Paul
Deneffe, Georges
Menten, Johan
Lerut, Antoon
Demedts, Maurice #
Issue Date: Jan-1998
Series Title: European Journal of Cardio-Thoracic Surgery vol:13 issue:1 pages:1-12
Abstract: Background: Surgical exploration in mediastinoscopy proven N2 non-small cell lung cancer (NSCLC) is unrewarding. Theoretical concepts suggest a beneficial role for preoperative induction treatment. The solidity of the therapeutic results with this approach in the currently available data is examined. Methods: Literature on induction therapy followed by surgical exploration, consisting of randomized reports and phase II reports meeting some essential criteria, are reviewed. Results: Of the twenty-four analyzed phase II studies, thirteen lack adequate surgical staging. Stratification for various important prognostic factors in N2 disease is missing in many instances. Results with induction with a cisplatinum dose of less than 80 mg/m(2) seem to be inferior. The use of mitomycin-C in patients scheduled for lung resection or irradiation deserves caution. No evident difference in efficacy between induction chemotherapy or chemo-radiotherapy is suggested, but toxicity and mortality appear to be somewhat higher with chemo-radiotherapy. Pathological complete response is mainly found after an at least partial clinical response. Effect on survival in non-controlled phase II studies and small randomized reports is encouraging. Conclusions: the role of chemotherapy induction in improving the long-term survival of N2 NSCLC is promising, but needs to be confirmed by large multi-center randomized data. Adequate surgical staging and attention to important prognostic factors in N2 disease should minimize the numerous institution based differences interfering in the currently available non-controlled studies. (C) 1998 Elsevier Science B.V.
ISSN: 1010-7940
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Thoracic Surgery
Anatomy Section (-)
Laboratory of Experimental Radiotherapy
× corresponding author
# (joint) last author

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