Biomaterial Database

Neoadjuvant chemotherapy in locally advanced non-small cell lung cancer. 2007

W Hamouda, and Y Dorgham, and A Yosry, and M Abdel Wahab

Department of Radiation Oncology, Faculty of Medicine, Zagazig University. walledham63@hotmail.com

OBJECTIVE The objective of this study was to evaluate the role of neoadjuvant chemotherapy in the treatment of locally advanced non small cell lung cancer (NSCLC) followed by radiotherapy versus radiotherapy alone. METHODS Sixty nine patients were randomized to chemotherapy (group A) or radiotherapy alone (group B). The induction chemotherapy consists of cisplatin (80 mg/m2) day 1 and Gemcitabine (1250 mg/m2), infusion day 1 and 8. Cycles were repeated every 3 weeks. Radiotherapy was given 4-6 weeks after chemotherapy to a dose of 60 Gy/30 fractions/6 weeks. RESULTS A total of 66 patients were evaluable for response; 34 in group A and 32 in group B. The overall response rate was 41.2% for group A and 21.8% for group B (P < 0.5) but with no complete response observed in either group. At a median follow up of 15 months, the overall survival was 65% and median survival was 12 months for group A. However in group B the overall survival at 15 months was 30% and the median survival was 9 nt (P < 0.001). Treatment toxicity in group A was mainly haemotological in 79% of patients none of them was grade II or IV. Grade Nausea and vomiting was reported in 73.5% of patients, grade I esophagitis in 5.8% of patients, grade I, radiation pneumonitis in 26.4% of patients. Alopecia was observed in 29.4% of patients, nephrotoxicity in 17.4%. Treatment toxicity in group B were generally less than in group A but not statistically significant except fr grade III vomiting (15.6%) and alopecia (0%). CONCLUSIONS Combination chemotherapy of cisplatin and gemcitabine is a tolerable and active induction chemotherapy regimen for patients with locally advanced NSCLC. Sequential radiotherapy given after induction chemotherapy is tolerable and offers a hope of improved locoregional control and survival compared with radiotherapy alone.

UI	MeSH Term	Description	Entries
D008175	Lung Neoplasms	Tumors or cancer of the LUNG.	Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009367	Neoplasm Staging	Methods which attempt to express in replicable terms the extent of the neoplasm in the patient.	Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D012074	Remission Induction	Therapeutic act or process that initiates a response to a complete or partial remission level.	Induction of Remission,Induction, Remission,Inductions, Remission,Remission Inductions
D002289	Carcinoma, Non-Small-Cell Lung	A heterogeneous aggregate of at least three distinct histological types of lung cancer, including SQUAMOUS CELL CARCINOMA; ADENOCARCINOMA; and LARGE CELL CARCINOMA. They are dealt with collectively because of their shared treatment strategy.	Carcinoma, Non-Small Cell Lung,Non-Small Cell Lung Cancer,Non-Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinoma,Nonsmall Cell Lung Cancer,Carcinoma, Non Small Cell Lung,Carcinomas, Non-Small-Cell Lung,Lung Carcinoma, Non-Small-Cell,Lung Carcinomas, Non-Small-Cell,Non Small Cell Lung Carcinoma,Non-Small-Cell Lung Carcinomas
D002294	Carcinoma, Squamous Cell	A carcinoma derived from stratified SQUAMOUS EPITHELIAL CELLS. It may also occur in sites where glandular or columnar epithelium is normally present. (From Stedman, 25th ed)	Carcinoma, Epidermoid,Carcinoma, Planocellular,Carcinoma, Squamous,Squamous Cell Carcinoma,Carcinomas, Epidermoid,Carcinomas, Planocellular,Carcinomas, Squamous,Carcinomas, Squamous Cell,Epidermoid Carcinoma,Epidermoid Carcinomas,Planocellular Carcinoma,Planocellular Carcinomas,Squamous Carcinoma,Squamous Carcinomas,Squamous Cell Carcinomas
D002945	Cisplatin	An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.	Platinum Diamminodichloride,cis-Diamminedichloroplatinum(II),cis-Dichlorodiammineplatinum(II),Biocisplatinum,Dichlorodiammineplatinum,NSC-119875,Platidiam,Platino,Platinol,cis-Diamminedichloroplatinum,cis-Platinum,Diamminodichloride, Platinum,cis Diamminedichloroplatinum,cis Platinum
D003131	Combined Modality Therapy	The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.	Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal