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Japanese Journal of Clinical Oncology 2005 35(1):6-12; doi:10.1093/jjco/hyi008
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© 2005 Foundation for Promotion of Cancer Research

Paclitaxel/Platinum-based Perioperative Chemotherapy and Surgery in Stage IIIA Non-small Cell Lung Cancer

In Sil Choi1, Do-Youn Oh1, Jung Hye Kwon1, Sang-Il Kim1, Sook Ryun Park1, Ji-Youn Bak1, Jee Hyun Kim1, Dong-Wan Kim1, Young Tae Kim2, Tae-You Kim1, Chul-Kyu You1, Young Whan Kim1, Dae Seog Heo1, Yung-Jue Bang1, Sook Whan Sung2, Chan-Il Park3 and Noe Kyeong Kim1

Departments of 1 Internal Medicine, 2 Thoracic and Cardiovascular Surgery and 3 Radiation Oncology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

For reprints and all correspondence: Young Whan Kim, Associate Professor, and Tae-You Kim, Assistant Professor, Department of Internal Medicine, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul, 110-744, Korea. E-mail: kimty{at}snu.ac.kr

Received August 12, 2004; accepted November 23, 2004

Objective: The objectives of the present study were to assess the efficacy and tolerability of perioperative paclitaxel/platinum-based chemotherapy and surgery in patients with stage IIIA clinical N2 (cN2) non-small cell lung cancer (NSCLC).

Methods: Clinical N2 was defined as either >15 mm or >10 mm and multiple nodes on computed tomography (CT) scan. Thirty-four chemotherapy-naïve patients with stage IIIA cN2 received preoperative paclitaxel/cisplatin for two cycles and then underwent surgery. The treatment with paclitaxel/carboplatin was repeated for three cycles after the operation.

Results: Of the 34 patients, none achieved a complete response (CR) and 22 achieved a partial response (PR), resulting in a response rate of 65%. Among 29 patients (85%) who had received thoracotomy, 25 (74%) underwent complete resection. Two pathological CRs were observed and mediastinal nodes were free of tumor in 21%. Grade 3–4 toxicity was uncommon and treatment-related mortality was not observed. The median time to progression (TTP) was 12.1 months [95% confidence interval (CI) 8.3–15.9 months] and median overall survival (OS) was 23.6 months (95% CI 17.7–30.2 months).

Conclusions: Paclitaxel/platinum-based perioperative chemotherapy and surgery for patients with stage IIIA cN2 NSCLC is effective and well tolerated.

Key Words: neoadjuvant chemotherapy • non-small cell lung cancer • paclitaxel • platinum


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