THE COMPARISON OF CAP CHEMOTHERAPY AND RADIOTHERAPY TO RADIOTHERAPY ALONE FOR RESECTED LUNG-CANCER WITH POSITIVE MARGIN OR INVOLVED HIGHESTSAMPLED PARATRACHEAL NODE (STAGE-IIIA) - LCSG-791

This study was conducted to determine the effect of adjuvant chemother apy on locally advanced resected non-small cell lung cancer. Anatomic eligibility requirements were either positive resection margins or tum or involvement of the highest sampled mediastinal lymph node. One hund red seventy-two patients were randomized to receive either postoperati ve thoracic irradiation alone or together with six cycles of CAP chemo therapy (cyclophosphamide, doxorubicin, and cisplatin). The chemothera py arm showed significantly longer recurrence-free survival (p=0.004). This benefit accrued to patients with both nonsquamous (p=0.01) and s quamous (p=0.08) cell carcinoma. At 1 year following randomization, th ere was a 14% difference in survival favoring the chemotherapy arm. Ch emotherapy significantly reduced distant metastases. Median survival w as 20 months for the chemotherapy arm and 13 months for the radiothera py alone arm. The 2-year survival rate for the entire study population was 35%. Toxic reactions were primarily predictable hematologic, GI, and alopecia toxicity expected from CAP. Esophagitis was not a signifi cant problem.