> Detailanzeige

Betticher, Daniel C.; Hsu Schmitz, Shu-Fang; Tötsch, Martin; Hansen, Eva; Joss, Christine; von Briel, Christian; Schmid, Ralph A.; Pless, Miklos; Habicht, James; Roth, Arnaud D.; Spiliopoulos, Anastase; Stahel, Rolf; Weder, Walter; Stupp, Roger; Egli, Fritz; Furrer, Markus; Honegger, Hanspeter; Wernli, Martin; Cerny, Thomas; Ris, Hans-Beat

Mediastinal Lymph Node Clearance After Docetaxel-Cisplatin Neoadjuvant Chemotherapy Is Prognostic of Survival in Patients With Stage IIIA pN2 Non–Small-Cell Lung Cancer: A Multicenter Phase II Trial

Literatur-
verwaltung

Zur
Merkliste

Lösche von
Merkliste

Per Whatsapp teilen

Schließen

Merkliste



Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
  • Medientyp: E-Artikel
  • Titel: Mediastinal Lymph Node Clearance After Docetaxel-Cisplatin Neoadjuvant Chemotherapy Is Prognostic of Survival in Patients With Stage IIIA pN2 Non–Small-Cell Lung Cancer: A Multicenter Phase II Trial
  • Beteiligte: Betticher, Daniel C.; Hsu Schmitz, Shu-Fang; Tötsch, Martin; Hansen, Eva; Joss, Christine; von Briel, Christian; Schmid, Ralph A.; Pless, Miklos; Habicht, James; Roth, Arnaud D.; Spiliopoulos, Anastase; Stahel, Rolf; Weder, Walter; Stupp, Roger; Egli, Fritz; Furrer, Markus; Honegger, Hanspeter; Wernli, Martin; Cerny, Thomas; Ris, Hans-Beat
  • Erschienen: American Society of Clinical Oncology (ASCO), 2003
  • Erschienen in: Journal of Clinical Oncology
  • Sprache: Englisch
  • DOI: 10.1200/jco.2003.11.040
  • ISSN: 0732-183X; 1527-7755
  • Schlagwörter: Cancer Research ; Oncology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p> Purpose: A multicenter, phase II trial investigated the efficacy and toxicity of neoadjuvant docetaxel-cisplatin in locally advanced non–small-cell lung cancer (NSCLC) and examined prognostic factors for patients not benefiting from surgery. </jats:p><jats:p> Patients and Methods: Ninety patients with previously untreated, potentially operable stage IIIA (mediastinoscopically pN2) NSCLC received three cycles of docetaxel 85 mg/m<jats:sup>2</jats:sup> day 1 plus cisplatin 40 mg/m<jats:sup>2</jats:sup> days 1 and 2, with subsequent surgical resection. </jats:p><jats:p> Results: Administered dose-intensities were docetaxel 85 mg/m<jats:sup>2</jats:sup>/3 weeks (range, 53 to 96) and cisplatin 95 mg/m<jats:sup>2</jats:sup>/3 weeks (range, 0 to 104). The 265 cycles were well tolerated, and the overall response rate was 66% (95% confidence interval [CI], 55% to 75%). Seventy-five patients underwent tumor resection with positive resection margin and involvement of the uppermost mediastinal lymph node in 16% and 35% of patients, respectively (perioperative mortality, 3%; morbidity, 17%). Pathologic complete response occurred in 19% of patients with tumor resection. In patients with tumor resection, downstaging to N0–1 at surgery was prognostic and significantly prolonged event-free survival (EFS) and overall survival (OS; P = .0001). At median follow-up of 32 months, the median EFS and OS were 14.8 months (range, 2.4 to 53.4) and 33 months (range, 2.4 to 53.4), respectively. Local relapse occurred in 27% of patients with tumor resection, with distant metastases in 37%. Multivariate analyses identified mediastinal clearance (hazard ratio, 0.22; P = .0003) and complete resection (hazard ratio, 0.26; P = .0006) as strongly prognostic for increased survival. </jats:p><jats:p> Conclusion: Neoadjuvant docetaxel-cisplatin is effective and tolerable in stage IIIA pN2 NSCLC. Resection is recommended only for patients with mediastinal downstaging after chemotherapy. </jats:p>