High-dose neoadjuvant chemoradiotherapy versus chemotherapy alone followed by surgery in potentially-resectable stage IIIA-N2 NSCLC: a multi-institutional retrospective study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)
High-dose neoadjuvant chemoradiotherapy versus chemotherapy alone followed by surgery in potentially-resectable stage IIIA-N2 NSCLC: a multi-institutional retrospective study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society)
Montemuiño, Sara; Rodríguez de Dios, Nuria; Martín, Margarita; Taboada, Begoña; Calvo Crespo, Patricia; Samper Ots, María Pilar; López Guerra, José Luis; López Mata, Miriam; Jové Teixidó, Josep; Díaz Díaz, Verónica; Ingunza Barón, Lourdes de; Murcia Mejía, Mauricio; Chust, Marisa; García Cañibano, Tamara; Couselo, María Luz; Puertas, María Mar; Cerro, Elia del; Moradiellos, Javier; Amor, Sergio; Varela, Andrés; Thuissard Vasallo, Israel John; Sanz Rosa, David; Couñago Lorenzo, Felipe
Background: The optimal induction treatment in potentially-resectable stage IIIA-N2 NSCLC remains undefined.
Aim: To compare neoadjuvant high-dose chemoradiotherapy (CRT) to neoadjuvant chemotherapy (CHT) in patients with resectable, stage IIIA-N2 non-small-cell lung cancer (NSCLC).
Methods: Retrospective, multicentre study of 99 patients diagnosed with stage cT1-T3N2M0 NSCLC who underwent neoadjuvant treatment (high-dose CRT or CHT) followed by surgery between January 2005 and December 2014.
Results: 47 patients (47.5%) underwent CRT and 52 (52.5%) CHT, with a median follow-up of 41 months. Surgery consisted of lobectomy (87.2% and 82.7%, in the CRT and CHT groups, respectively) or pneumonectomy (12.8% vs. 17.3%). Nodal downstaging (to N1/N0) and Pathologic complete response (pCR; pT0pN0) rates were significantly higher in the CRT group (89.4% vs. 57.7% and 46.8% vs. 7.7%, respectively; p < 0.001)). Locoregional recurrence was significantly lower in the CRT group (8.5% vs. 13.5%; p = 0.047) but distant recurrence rates were similar in the two groups. Median PFS was 45 months (CHT) vs. "not reached" (CRT). Median OS was similar: 61 vs. 56 months (p = 0.803). No differences in grade ≥3 to...