A prospective randomized study of adjuvant chemotherapy in completely resected stage III-N2 non small cell lung cancer

Abstract

Objective:To evaluate the effect of postoperative adjuvant chemotherapy on survival after complete resection of stage III-N2 non-small-cell lung cancer. Methods: From Jan. 1999 to Dec. 2003, one-hundred and fifty patients, who were diagnosed as stage III-N2 non-small cell lung cancer after operation, were randomly devided into chemotherapy group and control group. The former received four cycles of chemotherapy with NVB (25 mg/m 2 , D1, D5)/paclitaxel (175 mg/m 2 , D1) and Carboplatin (AUC=5, D1). Results: In chemotherapy group, 75.8% (68/79) of patients had finished the 4 cycles of chemotherapy and no one died of toxic effects of chemotherapy. Twenty-five percent of the patients had grade 3−4 neutropenia and 2% had febrile neutropenia. The median survival for the entire 150 patients was 879 d, with 1-year survival rate of 81%, 2-year survival rate of 59% and 3-year survival rate of 43%. There was no significant difference in median survival between chemotherapy and control group (897 d vs 821 d, P=0.0527), but there was significant difference in the 1-year and 2-year overall survival (94.71%, 76.28% vs 512 d, P=0.122), but there was significant difference in the 2-year survival rate between two groups with brain metastases (66.7% vs 37.6% P<0.05). The median survival after brain metastasis appeared was 190 days. Conclusion: Postoperative adjuvant chemotherapy does not significantly improve median survival among patients with completely resected stage II-N2 non-small-cell lung cancer, but significantly improves the 1-year and 2-year overall survival. It neither decreases the incidence of brain metastasis but put off the time of brain metastasis.

The Optimal Treatment for Stage IIIA-N2 Non-Small Cell Lung Cancer: A Network Meta-Analysis

“…The full text of 23 potentially eligible articles were retrieved for detailed assessment. After layers of screening, 18 RCTs [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were included with a total of 2,158 patients randomized to receive 1 of the following 13 treatments (Fig 2A ): surgery alone (S), radiotherapy alone (R), surgery followed by adjuvant chemotherapy (SC), surgery followed by adjuvant radiotherapy (SR), neoadjuvant chemotherapy followed by surgery (CS), sequential chemoradiotherapy (CR), concurrent chemoradiotherapy (C_R), neoadjuvant sequential chemoradiotherapy followed by surgery (CRS), neoadjuvant concurrent chemoradiotherapy followed by surgery (C_RS), neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy (CSC), neoadjuvant chemotherapy followed by surgery and adjuvant radiotherapy (CSR), surgery followed by adjuvant sequential chemoradiotherapy (SCR), and surgery followed by adjuvant concurrent chemoradiotherapy (SC_R). Detailed characteristics of eligible studies are summarized in Table 1 and Supplemental Table 3.…”

“…All 18 trials reported information on overall survival. HRs were estimated in 11 trials [25][26][27][28][29][30][31][32][33][34][35]. TrDeath was not reported in 2 studies [20,29].…”