Study of role of neoadjuvant chemotherapy in non-small lung cancer
Other Title(s)
دراسة دور المعالجة الكيميائية قبل العمل الجراحي في أورام الرئة غير صغيرة الخلايا
Author
Source
Damascus University Journal for Medical Sciences
Issue
Vol. 35, Issue 1 (30 Jun. 2019), pp.267-273, 7 p.
Publisher
Publication Date
2019-06-30
Country of Publication
Syria
No. of Pages
7
Main Subjects
Abstract EN
Background: Neoadjuvant chemotherapy for patients with non-smell lung cancer was studied before undergoing surgery according to the response.
Methods: 85 enrolled Patients treated from Jan 2009 till Dec 2011 with neoadjuvant chemotherapy.
75 pts males and 10 pts females.48 patients (56,5% ) had less than 60 years.
58 patients (68,2%) had Squamous cell carcinoma subtype (SCC) , while the other 27 patients (31,8%) had (Non SCC).
All patients underwent pretreatment evaluation at AL BAYROUNI University cancer center.
Some patients (32%) had complete mediastinoscopy staging, and all were believed to be poor candidates for up-front surgery because of the bulky disease.
Different chemotherapeutic protocols were employed (Gemcitabine/cisplatin) (Docetaxel/cisplatine) and (vinorelbine/ cisplatine).
Study end points included resectability, pathologic response, local-regional control,and the best chemotherapy regimen .
An exploratory comparison between pathologic response and both histology and age was performed.
On the other hand,An exploratory comparison between the three different regimens of chemotherapy was also done.
Results: Of the 85 patients, 26 (30,5%) were deemed surgical candidates after induction therapy however 7 patients of which (8,2%) refused surgery, were 27/85 males and 2/10 females had good downstaging P value (0.0001) and (0.0003) respectively with T downstaging 20/85 (23.5%), and N downstaging 18/85 (21.2%) but T+N downstaging was seen in only 9 patients (10.6%)P value (0,0001).The response to induction chemotherapy was 30/85 patients (35.2%) with one patient only (1.2%)` in a complete response .
furthermore, 26/85 patients were in objective response (30.5%) and while 3 patients (3,5%) had a stable disease.Regarding responders' age, there were 18/48 patients (37%) aged 60 years and less, and only 8/37 patients (21.6%) were over 60 years.Depending on response to histology, 21/58 patients (34.5%) of SCC had got a response to preoperative chemotherapy, P value (0,0015), while 10/27 patients (37%) had no SCC,P value ( 0,0295).50/85 patients (58.8%) treated by (Gemcitabine / Cisplatin) protocol with 15 responders( 30%) P value (0,0197 ),24/85 patients (28.2%) treated with (Vinorlbine / Cisplatin) protocol with 11 responders (45.8%) P value(0.0125) .
And finally,11/85 of pts (12,9%) treated by (docetaxel / cisplatin) protocol showed four responders (36.4%) P value ( 0,0332 ).
Conclusion: The preoperative chemotherapy gives a good response for a possible surgery in patients with stages IIIA and IIIB NSCLC.
this response was better in patients under 60 years , P value ( 0,0055 ).
With response was better seen in Vinorelbine and Cisplatin arm .
However , regarding histology based response, there was no preference.the former results lead us to use neoadjuvant chemotherapy in locally advanced NSCLC,but we still need a larger trials to reach the best protocol.
Background: Non-small cell lung cancer (NSCLC), primarily including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, accounts for approximately 80% - 85% of all lung cancers, and approximately two-thirds of NSCLC patients are found to have advanced-stage disease at diagnosis (1,3).
The standard of care for the initial treatment of these patients is a platinum-based, two-drug chemotherapy (2).
However, its therapeutic effect is limited and the prognosis of patients with advanced NSCLC remains poor(3,4).
American Psychological Association (APA)
Bashshur, Marwan. 2019. Study of role of neoadjuvant chemotherapy in non-small lung cancer. Damascus University Journal for Medical Sciences،Vol. 35, no. 1, pp.267-273.
https://search.emarefa.net/detail/BIM-1219726
Modern Language Association (MLA)
Bashshur, Marwan. Study of role of neoadjuvant chemotherapy in non-small lung cancer. Damascus University Journal for Medical Sciences Vol. 35, no. 1 (2019), pp.267-273.
https://search.emarefa.net/detail/BIM-1219726
American Medical Association (AMA)
Bashshur, Marwan. Study of role of neoadjuvant chemotherapy in non-small lung cancer. Damascus University Journal for Medical Sciences. 2019. Vol. 35, no. 1, pp.267-273.
https://search.emarefa.net/detail/BIM-1219726
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 272-273
Record ID
BIM-1219726