INDUCTION CHEMORADIOTHERAPY FOLLOWED BY SURGERY FOR STAGE-III NONSMALL CELL LUNG-CANCER

Twenty-five patients with stage III, non-small cell lung cancer were t reated with cisplatin-based chemotherapy and thoracic radiation therap y followed by surgery. Thirteen patients had stage IIIA disease and 12 , stage IIIB disease. The chemotherapy and radiotherapy were intensive ly combined with only a few days' interval between them. Radiation the rapy delivering a total dose of 50-70 Gy was started 10 days after the beginning of chemotherapy. A few additional courses of chemotherapy w ere repeated until a thoracotomy was performed. All but two surgically -treated patients underwent tumor resection, with 19 lobectomies and f our pneumonectomies. Eighteen patients underwent curative and five, no n-curative resections. Pathological examination of the resected specim en provided accurate intrathoracic information. Six patients (24%) sho wed a pathologically complete response, with no cancer cells detected in the resected specimens. Severe postoperative complications occurred in five patients (20%), with one death. The disease recurred in five of the 18 patients who underwent a curative resection. A second primar y tumor developed in two other patients. Seventeen patients (68%) are alive, with a median follow-up of 37 months after thoracotomy. The est imated three-year survival was 67% for all patients.