Neoadjuvant chemotherapy for early stage non-small cell lung cancer

Surgical resection alone is the standard treatment for early stage non-smal l cell lung cancer (NSCLC). Neoadjuvant chemotherapy followed by surgery ha s improved survival in regionally advanced NSCLC, so it is reasonable to st udy this approach in earlier stage disease. Prior to embarking on such a pr otocol, we reviewed our past experience with this treatment approach in an 'off protocol' setting. Platinum based combination chemotherapy was given t o 15 patients with clinical early stage NSCLC. Then surgical resection was done in all patients. Clinically, there were 12 (80%) partial responses and 2 (13%) minimal responses. The pathological stage was Stage I (T1-T2, N0) in all patients. There were no operative deaths, but one patient was readmi tted and ultimately died from pulmonary fibrosis secondary to mitomycin C t herapy. Pathological responses were seen in 10 of 15 resected specimens. Af ter a median follow-up of 17 months, seven (47%) patients are alive with no evidence of disease, three are alive with recurrence, one is alive with a second lung primary, and four have died (one of disease). Neoadjuvant chemo therapy followed by resection for early stage NSCLC is worthy of further in vestigation. Med Sci Res 26:853-854. (C) 1998 Lippincott Williams & Wilkins .