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Comparative Study
. 2012 Dec;15(6):954-60.
doi: 10.1093/icvts/ivs412. Epub 2012 Sep 12.

Induction chemoradiotherapy is superior to induction chemotherapy for the survival of non-small-cell lung cancer patients with pathological mediastinal lymph node metastasis

Shinichi Toyooka  1 , Katsuyuki Kiura, Kazuhiko Shien, Kuniaki Katsui, Katsuyuki Hotta, Susumu Kanazawa, Hiroshi Date, Shinichiro Miyoshi
Affiliations
Comparative Study

Induction chemoradiotherapy is superior to induction chemotherapy for the survival of non-small-cell lung cancer patients with pathological mediastinal lymph node metastasis

Shinichi Toyooka et al. Interact Cardiovasc Thorac Surg. 2012 Dec.

Abstract

Objectives: The purpose of this study was to compare the clinical outcomes of induction chemoradiotherapy and chemotherapy and to identify the prognostic factors for non-small-cell lung cancer patients with mediastinal lymph node metastasis who were treated with induction therapy.

Methods: Between August 1995 and December 2010, 50 non-small-cell lung cancer patients with pathological mediastinal lymph node metastasis were scheduled to receive induction therapy followed by surgery. Irinotecan plus cisplatin was used for induction chemotherapy from June 1995 to April 1999, and docetaxel plus cisplatin with concurrent radiation at a dose of 40-46 Gy has been used for induction chemoradiotherapy since May 1999.

Results: Thirty-five patients were treated with induction chemoradiotherapy and 15 were treated with induction chemotherapy. For the entire population, the 3-year and 5-year overall survival rates were 64.1 and 53.9%, respectively, and the 1-year and 2-year disease-free survival rates were 70.0 and 53.1%, respectively. Among the clinicopathological factors, the chemoradiotherapy group exhibited longer overall survival and disease-free survival than the chemotherapy group (overall survival, P = 0.0020; disease-free survival, P = 0.015). Pathological downstaging was also significantly associated with favorable overall survival (P = 0.0042) and disease-free survival (P = 0.021). A multivariate analysis showed that chemoradiotherapy (P = 0.0099) and pathological downstaging (P = 0.039) were independent prognostic factors.

Conclusions: Our results indicated that induction chemoradiotherapy was superior to induction chemotherapy with regard to the outcome of non-small-cell lung cancer patients with mediastinal lymph node metastasis.

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Figures

Figure 1:
Figure 1:
Survival curves stratified by induction therapy. (a) Overall survival; (b) disease-free survival. ChRT: chemoradiotherapy; ChT: chemotherapy.
Figure 2:
Figure 2:
Survival curves stratified by pathological downstaging. (a) Overall survival; (b) disease-free survival.
See this image and copyright information in PMC

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