Induction Chemoradiotherapy and Surgical Resection for Selected Stage IIIB Non-Small-Cell Lung Cancer

Yukito Ichinose, Yasuro Fukuyama, Hiroshi Asoh, Chie Ushijima, Tatsuro Okamoto, Jiro Ikeda, Junichi Okamoto, Maki Sakai

Research output: Contribution to journalArticle

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Abstract

Background. Combination chemotherapy using an oral combination of uracil and tegafur (UFT) plus cisplatin and concurrent thoracic radiotherapy is reported to have a high response rate and less toxicity for locally advanced non-small-cell lung cancer (NSCLC) patients. We performed a phase II trial using this chemoradiotherapy as an induction treatment. Methods. Patients with marginally resectable stage IIIB NSCLC, an age younger than 70 years, a performance status of 0 or 1, and good organ function were eligible. The UFT (400 mg/m2) was administered orally on days 1 through 14 and 22 through 35 and cisplatin (80 mg/m2) was injected intravenously on days 8 and 29. Radiotherapy with a total dose of 40 Gy was delivered in 20 fractions from day 1. A surgical resection was performed from 3 to 6 weeks after completing the induction treatment. Results. Twenty-seven patients, 18 male and 9 female with a median age of 56 years and ranging from 36 to 69 years, were entered into the phase II trial. Clinical T4 and N3 cancers were observed in 22 and 7 patients, respectively. Twenty-five (93%) achieved a partial response. The most frequently observed adverse event was grade 3 leukopenia in 26%. Of 25 patients who underwent a thoracotomy, 22 had a tumor resection. In all 22 patients a complex resection including a resection of the superior vena cava, carina, and vertebrae was required. Operative morbidity and mortality rates were 36% and 4% respectively. The calculated 1-year and 3-year survival rates of all 27 patients were 73% and 56% respectively. Conclusions. Chemotherapy using UFT plus cisplatin and concurrent radiotherapy as induction treatment and a surgical resection for patients with marginally resectable stage IIIB NSCLC is feasible and promising. However it is difficult to conduct multi-institutional trials even for selected stage IIIB disease as a complex resection in almost all patients is necessary.

Original languageEnglish
Pages (from-to)1810-1814
Number of pages5
JournalAnnals of Thoracic Surgery
Volume76
Issue number6
DOIs
Publication statusPublished - Jan 1 2003

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Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Cisplatin
Radiotherapy
Tegafur
Superior Vena Cava
Uracil
Leukopenia
Thoracotomy
Combination Drug Therapy
Neoplasms
Spine
Thorax
Therapeutics
Survival Rate
Morbidity
Drug Therapy
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ichinose, Y., Fukuyama, Y., Asoh, H., Ushijima, C., Okamoto, T., Ikeda, J., ... Sakai, M. (2003). Induction Chemoradiotherapy and Surgical Resection for Selected Stage IIIB Non-Small-Cell Lung Cancer. Annals of Thoracic Surgery, 76(6), 1810-1814. https://doi.org/10.1016/S0003-4975(03)01075-0

Induction Chemoradiotherapy and Surgical Resection for Selected Stage IIIB Non-Small-Cell Lung Cancer. / Ichinose, Yukito; Fukuyama, Yasuro; Asoh, Hiroshi; Ushijima, Chie; Okamoto, Tatsuro; Ikeda, Jiro; Okamoto, Junichi; Sakai, Maki.

In: Annals of Thoracic Surgery, Vol. 76, No. 6, 01.01.2003, p. 1810-1814.

Research output: Contribution to journalArticle

Ichinose, Y, Fukuyama, Y, Asoh, H, Ushijima, C, Okamoto, T, Ikeda, J, Okamoto, J & Sakai, M 2003, 'Induction Chemoradiotherapy and Surgical Resection for Selected Stage IIIB Non-Small-Cell Lung Cancer', Annals of Thoracic Surgery, vol. 76, no. 6, pp. 1810-1814. https://doi.org/10.1016/S0003-4975(03)01075-0
Ichinose, Yukito ; Fukuyama, Yasuro ; Asoh, Hiroshi ; Ushijima, Chie ; Okamoto, Tatsuro ; Ikeda, Jiro ; Okamoto, Junichi ; Sakai, Maki. / Induction Chemoradiotherapy and Surgical Resection for Selected Stage IIIB Non-Small-Cell Lung Cancer. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 6. pp. 1810-1814.
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AU - Ichinose, Yukito

AU - Fukuyama, Yasuro

AU - Asoh, Hiroshi

AU - Ushijima, Chie

AU - Okamoto, Tatsuro

AU - Ikeda, Jiro

AU - Okamoto, Junichi

AU - Sakai, Maki

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N2 - Background. Combination chemotherapy using an oral combination of uracil and tegafur (UFT) plus cisplatin and concurrent thoracic radiotherapy is reported to have a high response rate and less toxicity for locally advanced non-small-cell lung cancer (NSCLC) patients. We performed a phase II trial using this chemoradiotherapy as an induction treatment. Methods. Patients with marginally resectable stage IIIB NSCLC, an age younger than 70 years, a performance status of 0 or 1, and good organ function were eligible. The UFT (400 mg/m2) was administered orally on days 1 through 14 and 22 through 35 and cisplatin (80 mg/m2) was injected intravenously on days 8 and 29. Radiotherapy with a total dose of 40 Gy was delivered in 20 fractions from day 1. A surgical resection was performed from 3 to 6 weeks after completing the induction treatment. Results. Twenty-seven patients, 18 male and 9 female with a median age of 56 years and ranging from 36 to 69 years, were entered into the phase II trial. Clinical T4 and N3 cancers were observed in 22 and 7 patients, respectively. Twenty-five (93%) achieved a partial response. The most frequently observed adverse event was grade 3 leukopenia in 26%. Of 25 patients who underwent a thoracotomy, 22 had a tumor resection. In all 22 patients a complex resection including a resection of the superior vena cava, carina, and vertebrae was required. Operative morbidity and mortality rates were 36% and 4% respectively. The calculated 1-year and 3-year survival rates of all 27 patients were 73% and 56% respectively. Conclusions. Chemotherapy using UFT plus cisplatin and concurrent radiotherapy as induction treatment and a surgical resection for patients with marginally resectable stage IIIB NSCLC is feasible and promising. However it is difficult to conduct multi-institutional trials even for selected stage IIIB disease as a complex resection in almost all patients is necessary.

AB - Background. Combination chemotherapy using an oral combination of uracil and tegafur (UFT) plus cisplatin and concurrent thoracic radiotherapy is reported to have a high response rate and less toxicity for locally advanced non-small-cell lung cancer (NSCLC) patients. We performed a phase II trial using this chemoradiotherapy as an induction treatment. Methods. Patients with marginally resectable stage IIIB NSCLC, an age younger than 70 years, a performance status of 0 or 1, and good organ function were eligible. The UFT (400 mg/m2) was administered orally on days 1 through 14 and 22 through 35 and cisplatin (80 mg/m2) was injected intravenously on days 8 and 29. Radiotherapy with a total dose of 40 Gy was delivered in 20 fractions from day 1. A surgical resection was performed from 3 to 6 weeks after completing the induction treatment. Results. Twenty-seven patients, 18 male and 9 female with a median age of 56 years and ranging from 36 to 69 years, were entered into the phase II trial. Clinical T4 and N3 cancers were observed in 22 and 7 patients, respectively. Twenty-five (93%) achieved a partial response. The most frequently observed adverse event was grade 3 leukopenia in 26%. Of 25 patients who underwent a thoracotomy, 22 had a tumor resection. In all 22 patients a complex resection including a resection of the superior vena cava, carina, and vertebrae was required. Operative morbidity and mortality rates were 36% and 4% respectively. The calculated 1-year and 3-year survival rates of all 27 patients were 73% and 56% respectively. Conclusions. Chemotherapy using UFT plus cisplatin and concurrent radiotherapy as induction treatment and a surgical resection for patients with marginally resectable stage IIIB NSCLC is feasible and promising. However it is difficult to conduct multi-institutional trials even for selected stage IIIB disease as a complex resection in almost all patients is necessary.

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