A PHASE-II STUDY OF NEOADJUVANT CHEMOTHERAPY WITH CISPLATIN, EPIRUBICIN AND VP-16 FOR STAGE-III UNRESECTABLE NONSMALL CELL LUNG-CANCER

Background. The survival rate for surgically resected stage III N2 non -small cell lung cancer (NSCLC) patients is less than 10%. Methods: A phase II study of cisplatin, epirubicin, and VP-16 (PEV) was undertake n in an attempt to improve the curative potential of surgery. Forty-on e patients with stage III N2 NSCLC received 3 cycles of PEV; Patients with either complete response (CR) or partial response (PR) underwent surgery and 3 additional courses of PEV. Results: The response rate in the whole patient population was 58%. Eighteen patients were resected ; twelve resections were complete and 6 were incomplete. Toxicity was mild and consisted mainly of myelosuppression. Twenty-six patients hav e died, and the median survival of all 41 patients was 18.1 months, wi th a 3-year survival of 23%. The median survival for those patients wh o were resected was 27 months with a 3-year survival of 42%. Conclusio ns: PEV is an effective low toxic drug combination for limited NSCLC.