A PHASE-II TRIAL OF COMBINED CHEMOTHERAPY AND SURGERY IN STAGE IIIA NONSMALL CELL LUNG-CANCER

A poor prognosis for patients with Stage IIIA clinical N2 treated by s urgery alone has led clinical researchers to find a new treatment moda lity to improve the curative potential of surgery. Many Phase II trial s have been carried out with induction chemo- or chemo-radiotherapy pr ior to surgery. From June 1988 to July 1991, 46 patients with non-smal l cell lung cancer (NSCLC) Stage IIIA clinical N2 entered a Phase II i nduction-chemotherapy trial. Patients received 2-3 cycles of high-dose cisplatin and etoposide. Forty-five were evaluable for response; the response rate was 82% (37/45: 3 CR, 34 PR). Toxicity was primarily hem atologic. Surgical resection was performed in 35 patients; radical res ection was possible in 28 patients (62%); three patients were incomple tely resected and two patients were only explored. Three deaths were s urgery-related. Median survival was 24.5 months with a 2-year survival of 53%. Cisplatin with etoposide is an active and safe induction chem otherapy regimen for NSCLC Stage IIIA N2 with a high response rate. Th e median survival seems to be prolonged and therefore, randomized tria ls are needed to compare this approach with other treatment modalities .