Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2006 Apr 24;94(8):1099-106.
doi: 10.1038/sj.bjc.6603075.

Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study

D C Betticher  1 , S-F Hsu Schmitz, M Tötsch, E Hansen, C Joss, C von Briel, R A Schmid, M Pless, J Habicht, A D Roth, A Spiliopoulos, R Stahel, W Weder, R Stupp, F Egli, M Furrer, H Honegger, M Wernli, T Cerny, H-B Ris; Swiss Group for Clinical Cancer Research (SAKK)
Affiliations
Clinical Trial

Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study

D C Betticher et al. Br J Cancer. .

Abstract

The aim was to investigate the efficacy of neoadjuvant docetaxel-cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m-2 (day 1) plus cisplatin 40 or 50 mg m-2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel-cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall survival (patients who underwent surgery, n=75).
Figure 2
Figure 2
Risk of (A) distant metastases stratified by pathological response (percentage of tumour necrosis and fibrosis), (B) distant metastases stratified by mediastinal downstaging (N0/1 vs N2), (C) local relapse stratified by pathological response and (D) local relapse stratified by mediastinal downstaging. The risk of developing distant metastases decreased rapidly after 24 months in patients where chemotherapy was active. Conversely, local relapses occurred throughout the entire observation period.
See this image and copyright information in PMC

References

    1. Albain KS, Rusch VW, Crowley JJ, Rice TW, Turrisi III AT, Weick JK, Lonchyna VA, Presant CA, McKenna RJ, Gandara DR (1995) Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA (N2) and IIIB non-small-cell lung cancer: mature results of Southwest Oncology Group phase II study 8805. J Clin Oncol 13: 1880–1892 - PubMed
    1. Albain KS, Scott CB, Rusch VR, Turrisi AT, Shepherd SA, Smith C, Gandara DR, Johnson D, Green MR, Miller RC (2003) Phase III study of concurrent chemotherapy and full course radiotherapy (CR/RT) versus CT/RT induction followed by surgical resection for stage IIIA(pN2) non-small cell lung cancer (NSCLC): first outcome analysis of North American Intergroup trial 0139 (RTOG 93-09). Lung Cancer 41(Suppl 2): S4 PL-4
    1. Albain KS, Swann RS, Rusch VR, Turrisi AT, Shepherd FA, Smith CJ, Gandara DR, Johnson DH, Green MR, Miller RC, the North American Lung Cancer Intergroup (2005) Phase III study of concurrent chemotherapy and radiotherapy (CT/RT) vs CT/RT followed by surgical resection for stage IIIA(pN2) non-small cell lung cancer (NSCLC): outcomes update of North American Intergroup 0139 (RTOG 9309). J Clin Oncol 23(Suppl 16S): 624s (Abstr 7014)
    1. Andre F, Grunenwald D, Pujol JL, Girard P, Dujon A, Brouchet L, Brichon PY, Westeel V, Le Chevalier T (2001) Patterns of relapse of N2 nonsmall-cell lung carcinoma patients treated with preoperative chemotherapy: should prophylactic cranial irradiation be reconsidered? Cancer 91: 2394–2400 - PubMed
    1. Arriagada R, Bergman B, Dunant A, Le Chevalier T, Pignon JP, Vansteenkiste J, the International Adjuvant Lung Cancer Trial Collaborative Group (2004) Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med 350: 351–360 - PubMed

Publication types

MeSH terms