TY - JOUR
T1 - Induction chemoradiotherapy using docetaxel and cisplatin with definitive-dose radiation followed by surgery for locally advanced non-small cell lung cancer
AU - Torigoe, Hidejiro
AU - Sou, Junichi
AU - Tomida, Shuta
AU - Namba, Kei
AU - Sato, Hiroki
AU - Katsui, Kuniaki
AU - Hotta, Katsuyuki
AU - Shien, Kazuhiko
AU - Yamamoto, Hiromasa
AU - Yamane, Masaomi
AU - Kanazawa, Susumu
AU - Kiura, Katsuyuki
AU - Miyoshi, Shinichiro
AU - Toyooka, Shinichi
N1 - Publisher Copyright:
© Journal of Thoracic Disease.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: Induction chemoradiotherapy (CRT) followed by surgery is a therapeutic option for locally advanced non-small cell lung cancer (LA-NSCLC). Typically, around 40-50 Gy of radiation is applied as the induction-dose; however, a definitive-dose (DD) of radiation (60 Gy or higher) is occasionally applied to increase local control. We investigated the impact of induction CRT with DD radiation in LA-NSCLC patients treated with a single regimen of docetaxel and cisplatin. Methods: We reviewed 110 patients with LA-NSCLC who underwent induction CRT followed by surgery using a single regimen (docetaxel and cisplatin) between January 1999 and December 2014 at our hospital. The clinical outcomes of a DD group (60 Gy or higher, n=11) and a non-DD group (less than 60 Gy, n=99) were investigated using a propensity score (PS)-matched analysis. Results: An advanced clinical stage was significantly more common in the DD group than in the non- DD group (P=0.033). Before and after the PS-matching based on seven factors including clinical stage, there was no significant difference in the rates of postoperative (PO) complication, mortality, 5-year overall survival (OS), or 5-year recurrence-free survival (RFS) between the two groups. After the PS-matching, the pathological complete response (CR) rate was significantly higher in the DD group than in the non-DD group [50% (n=5/10) vs. 0% (n=0/10), P=0.033]. Conclusions: Induction CRT followed by surgery using docetaxel and cisplatin with DD radiation can be performed safely and is associated with a higher pathological CR rate than that attained using non-DD radiation in LA-NSCLC patients.
AB - Background: Induction chemoradiotherapy (CRT) followed by surgery is a therapeutic option for locally advanced non-small cell lung cancer (LA-NSCLC). Typically, around 40-50 Gy of radiation is applied as the induction-dose; however, a definitive-dose (DD) of radiation (60 Gy or higher) is occasionally applied to increase local control. We investigated the impact of induction CRT with DD radiation in LA-NSCLC patients treated with a single regimen of docetaxel and cisplatin. Methods: We reviewed 110 patients with LA-NSCLC who underwent induction CRT followed by surgery using a single regimen (docetaxel and cisplatin) between January 1999 and December 2014 at our hospital. The clinical outcomes of a DD group (60 Gy or higher, n=11) and a non-DD group (less than 60 Gy, n=99) were investigated using a propensity score (PS)-matched analysis. Results: An advanced clinical stage was significantly more common in the DD group than in the non- DD group (P=0.033). Before and after the PS-matching based on seven factors including clinical stage, there was no significant difference in the rates of postoperative (PO) complication, mortality, 5-year overall survival (OS), or 5-year recurrence-free survival (RFS) between the two groups. After the PS-matching, the pathological complete response (CR) rate was significantly higher in the DD group than in the non-DD group [50% (n=5/10) vs. 0% (n=0/10), P=0.033]. Conclusions: Induction CRT followed by surgery using docetaxel and cisplatin with DD radiation can be performed safely and is associated with a higher pathological CR rate than that attained using non-DD radiation in LA-NSCLC patients.
KW - Definitive-dose radiation (DD radiation)
KW - Induction chemoradiotherapy (induction CRT)
KW - Non-small cell lung cancer (NSCLC)
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U2 - 10.21037/jtd.2017.08.87
DO - 10.21037/jtd.2017.08.87
M3 - Article
AN - SCOPUS:85030110324
VL - 9
SP - 3076
EP - 3086
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
IS - 9
ER -