O-035 Phase III trial of concurrent chemotherapy and radiotherapy(CT/RT) vs CT/RT followed by surgical resection for stage IIIa(pN2)non-small cell lung cancer (NSCLC): Outcomes and implications for surgical management in North American Intergroup 0139 (RTOG 9309)

Rusch, Valerie W.; Albain, Kathy S.; Turrisi, Andrew; Swann, S.; Shepherd, Frances A.; Chen, Y.; Livingston, Robert B.; Darling, Gail; Cox, Joan; Sause, W.

doi:10.1016/s0169-5002(05)80167-9

Cited by 17 publications

(3 citation statements)

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“…These time-scales, as well as other variables of long time survival such as overall survival and 2nd, 3rd, and 5th year survival rates (although not the primary end point of the present study, and for this reason is statistically underpowered), are comparable for our two treatment groups. These results are within the ranges reported by most studies evaluating combined modalities of treatment, including the EORTC study in patients with stage IIIA comparing surgery with radiotherapy after induction chemotherapy showing no difference between both radical modalities [31][32][33].…”

Section: Discussionsupporting

confidence: 81%

Cisplatin plus gemcitabine with or without vinorelbine as induction chemotherapy prior to radical locoregional treatment for patients with stage III non-small-cell lung cancer (NSCLC): Results of a prospective randomized study

et al. 2007

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Section: Discussionsupporting

confidence: 81%

Cisplatin plus gemcitabine with or without vinorelbine as induction chemotherapy prior to radical locoregional treatment for patients with stage III non-small-cell lung cancer (NSCLC): Results of a prospective randomized study

et al. 2007

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“…The US intergroup trial 0139 after induction with 45 Gy and concurrently given two cycles Cisplatin/Etoposide randomized to continuing radiotherapy to 61 Gy versus surgery; thereafter in both arms 2 further chemotherapy cycles have been given; with 23,6 : 22,2 months there was no significant difference in the median overall survival [11]. In the EORTC 08941 trial all patients received 3 cycles chemotherapy; hence only the patients with complete or partial response were randomized to radiotherapy with 60 Gy or to surgery with optional postoperative radiotherapy; with 16,4 : 16,0 months there was no difference in the median overall survival [12].…”

Section: Discussionmentioning

confidence: 99%

NSCLC: Primary Tumor Size – Radiation Dose-related Accelerated, Twice Daily Radiotherapy by Target Splitting, Preceded by 2 Cycles of Chemotherapy – First Results of a Prospective Study

et al. 2007

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“…Kartais po chemoterapijos, atliktos prieð operacijà, bûtina pakartotinai iðtirti tarpuplauèio limfmazgiø bûklae, nes tai padëtø atrinkti ligonius, kuriuos galima gydyti operaciniu bûdu. Kai kurie tarptautiniai tyrimai -Inter grupës 0139 [13,14] ir EORTC 08941 [15,16] -parodë, kad ligoniams po indukcinës chemoterapijos pailgëjo ligos atsinaujinimo laikas, o tiems, kuriems sumaþëjo stadija, pailgëjo gyvenimo trukmë. Taip pat autoriai paþymëjo, kad po indukcinës chemoterapijos buvo maþiau vietiniø ligos recidyvø.…”

Section: Diskusijaunclassified

Mediastinoskopijos svarba vertinant plaučių vėžio išplitimą į tarpuplautį

Cicėnas¹,

Naujokaitis²,

Piščikas³

et al. 2007

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Saulius Cicėnas, Pranas Naujokaitis, Dainius Piščikas, Arnoldas Krasauskas, Renatas AškinisVilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyrius,Santariškių g. 1, LT-08660 VilniusEl paštas: cicenas@loc.lt Tikslas Įvertinti mediastinoskopijos svarbą diagnozuojant plaučių vėžio plitimą į tarpuplaučio limfmazgius, šios procedūros komplikacijas ir patikimumą. Ligoniai ir metodai Vilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyriuje 2001–2006 m. buvo atliktos 184 kaklinės mediastinoskopijos, kurių tikslas – įvertinti plaučių vėžio plitimą į tarpuplaučio limfmazgius. Mediastinoskopijos metu 85 (46,2%) ligoniams buvo pašalinti limfmazgiai iš kairės ir dešinės tarpuplaučio zonų, 15 (8,2%) ligonių – iš trachėjos keteros viršutinių ir apatinių zonų ir 84 (45,6%) ligoniams limfmazgiai buvo šalinami iš visų mediastinoskopijos metu prieinamų limfmazgių zonų (tarp jų 6 (7,1%) ligoniams iš kairės pusės aortos pulmoninių limfmazgių). Rezultatai Komplikacijų buvo 18 (9,8%) ligonių: kraujavimas iš dešinės pusės arterijos (A1) – 2 (1,1%) ligoniams, pneumotoraksas – 9 (4,9%), mediastinitas – 1 (0,5%), tarpuplaučio hematoma – 3 (1,6%), žaizdos supūliavimas – 3 (1,6%). Naviko diagnozė morfologiškai buvo patvirtinta 65,3% atvejais. Atliekant mediastinoskopiją, iš pradžių buvo palpaciniu būdu patikrinamas priekinis tarpuplautis bei šalinami padidėję, kieti tarpuplaučio limfmazgiai. Kraujavimas stabdytas prideginant ar naudojant metalinius spaustukus. Dažniausiai tarpuplautis nebuvo drenuojamas, tačiau baigus procedūrą tarpuplautyje buvo paliekama hemostatinė kempinė. Tyrimo jautrumas pasiektas 81% atvejų, specifiškumas – 100%, tikslumas – 97%, teigiama dianostinė vertė – 1,0%, neigiama – 0,91%. Išvados Kaklinė mediastinoskopija yra tikslus (97% atvejų), jautrus (81%) ir specifiškas (100%) plaučių vėžio plitimo į tarpuplaučio limfmazgius mikroinvazinis diagnostikos metodas. Įvaldžius šio metodo technines galimybes, galima saugiai pašalinti (atlikti biopsijas) iš įvairių zonų visus įtartinus tarpuplaučio limfmazgius. Morfologiškai diagnozė buvo patvirtinta 65,3% atvejų. Pooperacinių komplikacijų skaičius siekė 9,8%. Mirčių nebuvo. Pagrindiniai žodžiai: mediastinoskopija, plaučių vėžys, plitimas į tarpuplaučio limfmazgius Cervical mediastinoscopy in evaluating lung cancer metastases Saulius Cicėnas, Pranas Naujokaitis, Dainius Piščikas, Arnoldas Krasauskas, Renatas AškinisVilnius University, Institute of Oncology, Department of Thoracic Surgery and Oncology,Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: cicenas@loc.lt Objective To evaluate role of cervical mediastinoscopy in the diagnosis of lung cancer metastases to mediastinal lymph nodes, complication rate and prevalence. Patients and methods In 2001–2006, 184 cervical mediastinoscopies were performed at Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. In 85 (46.2%) pts lymph nodes were removed from the left and right mediastinal zones, in 15 (8.2%) pts from supra and infra carinal regions, and in 84 (45.6%) pts lymph nodes were removed from all accessible zones in the mediastinum (including 6 (7.1%) pts from the left aorto-pulmonar region). Results Complications after the procedures were observed in 18 (9.8%) pts: bleeding from the right superior artery (A1) 2 (1.1%) pts, pneumothorax – 9 (4.9%) pts, mediastinitis – 1 (0.5%) pt, hematoma of mediastinum – 3 (1.6%) pts and vulnar infection – 3 (1.6%) pts. Morphology was achieved in 65.3% of cases. During mediastinoscopy, the front mediastinum was examined by finger and enlarged lymph nodes were removed. Bleeding was stopped by cautery and using clips. Routinely we leave the hemostatic sponge in the mediastinum. No drainage was used. Sensitivity was achieved in 81% cases, specificity in 100% cases, accuracy in 97% cases, positive predictive value – 1%, negative – 0.91% cases. Conclusions Cervical mediastinoscopy is an accurate (97%), sensitive (81%), specific (100%) diagnostic method of lung cancer speard to the mediastinum. For an experienced physician, this method is safe and allows removing lymph nodes from various regions of the mediastinum. The diagnosis was morphologically proved in 65.3% of cases. Postoperative complication rate was 9.8% cases. We had no deaths after the procedures. Keywords: mediastinoscopy, lung cancer, spread to mediastinum lymph nodes

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O-035 Phase III trial of concurrent chemotherapy and radiotherapy(CT/RT) vs CT/RT followed by surgical resection for stage IIIa(pN2)non-small cell lung cancer (NSCLC): Outcomes and implications for surgical management in North American Intergroup 0139 (RTOG 9309)

Cited by 17 publications

References 0 publications

Cisplatin plus gemcitabine with or without vinorelbine as induction chemotherapy prior to radical locoregional treatment for patients with stage III non-small-cell lung cancer (NSCLC): Results of a prospective randomized study

Cisplatin plus gemcitabine with or without vinorelbine as induction chemotherapy prior to radical locoregional treatment for patients with stage III non-small-cell lung cancer (NSCLC): Results of a prospective randomized study

NSCLC: Primary Tumor Size – Radiation Dose-related Accelerated, Twice Daily Radiotherapy by Target Splitting, Preceded by 2 Cycles of Chemotherapy – First Results of a Prospective Study

Mediastinoskopijos svarba vertinant plaučių vėžio išplitimą į tarpuplautį

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