SURGERY OF LOCALLY ADVANCED NON-SMALL-CEL L LUNG-CANCER FOLLOWING INTENSIVE PREOPERATIVE CHEMOTHERAPY PLUS RADIOTHERAPY

From March 1991 to June 1993 50 patients with local advanced NSCLC (me diastinoscopy obligatory) have been entered into an ongoing trial with preoperative chemotherapy and simultaneous chemo-/radiotherapy, follo wed by re-mediastinoscopy and surgery. Clinical response rates after c hemotherapy amounted to 66.8 % after chemo/radiotherapy 77.5 %, no sev ere toxicity was observed. 36 patients ultimately underwent operation, 29 with a curative, 5 with a palliative resection and 2 with an explo rative thoracotomy. Pathological complete remission rates of the prima ry tumor were found in 11 (32.3 %), RO-resection in 18 (52.9 %) and R1 -resection in 5 (14.7 %) cases. Sterilisation rates of mediastinal nod es were found in 86.3 % of N2 tumors and 66.6 % of N3 tumors. Median s urvival time ranged between 21 months for stage IIIa and 16 months for IIIb disease. This intensive preoperative neoadjuvant treatment is to lerable and effective, the requirements for a randomised comparative t rial was met.