NEOADJUVANT CISPLATIN AND ETOPOSIDE FOR STAGE IIIA (CLINICAL N2) NONSMALL CELL LUNG-CANCER

In an attempt to improve the curative potential of surgery, 46 patient s with unresectable Stage IIIA (Clinical N2) non-small cell lung cance r received neoadjuvant chemotherapy with cisplatin and etoposide. Afte r 2 or 3 cycles, 45 patients were evaluable for response; the overall response rate was 82% (37/45) with 3 complete and 34 partial responses . Toxicity was primarily hematologic. Surgical exploration was perform ed on 35 patients, but resection was possible in only 33 (73%). Of the se, 28 resections were complete (62%). Four patients (2CR, 2PR; 9%) ha d no tumor in biopsy specimen. Three deaths were surgery-related. Medi an survival of the entire 46 patients was 24.5 months with a 2-year su rvival of 53%. Cisplatin and etoposide is an effective chemotherapeuti c regimen for regionally advanced non-small cell lung cancer; the rese ction and survival rates justify fur-ther trials to compare this appro ach to other treatment modalities.