Survival Benefit of Neoadjuvant Chemotherapy in Non-small Cell Lung Cancer: An Updated Meta-Analysis of 13 Randomized Control Trials

Song, Weian; Zhou, Nina; Wang, Wei; Chu, Xiangyang; Liang, Chaoyang; Tian, Xiaodong; Guo, Jialong; Liu, Xi; Liu, Yang; Dai, Weimin

doi:10.1097/jto.0b013e3181cd3345

Cited by 197 publications

(125 citation statements)

References 41 publications

(67 reference statements)

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“…9 Despite such serious adverse effects, survival is improved with preoperative neoadjuvant chemotherapy (NAC) followed by surgery, compared with surgery alone. [10][11][12] By reducing the tumor burden and downgrading the tumor stage, NAC facilitates surgical resection and may improve long-term outcome by eradicating micrometastases. But NAC may be a double-edged sword.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Peak Oxygen Uptake in Lung Cancer Subjects With Neoadjuvant Chemotherapy: A Cross-Sectional Study

et al. 2016

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BACKGROUND:In non-small-cell lung cancer patients, high peak oxygen uptake (peak V O 2 ) predicts lower rates of postoperative complications and better long-term survival. Neoadjuvant chemotherapy (NAC) may negatively impact peak V O 2 . METHODS: Cardiopulmonary exercise testing (CPET) was performed in 34 consecutive stage IIIA/IIIB non-small-cell lung cancer subjects scheduled for elective lung surgery. Using multivariate linear regression adjusted for potential confounders, we compared CPET results in subjects receiving or not receiving NAC (NAC؉, n ‫؍‬ 19; NAC؊, n ‫؍‬ 15). RESULTS: Adjusted peak V O 2 was lower in NAC ؉ compared with NAC؊ subjects (؊5.3 mL/min/kg [95% CI ؊8.3 to ؊2.2], P ‫؍‬ .01). Likewise, oxygen pulse, maximal work load, and ventilatory threshold were also lower in NAC؉ subjects, whereas peak heart rate and breathing reserve were similar. NAC؉ subjects presented lower values of diffusion capacity for carbon monoxide (D LCO ) (P ‫؍‬ .035) and hemoglobin concentrations (P < .001). D LCO was strongly correlated with peak V O 2 (r 2 ‫؍‬ 0.56). Adjustment for D LCO reduced the effect of NAC on peak V O 2 without suppressing it. CONCLUSIONS: NAC was associated with lower preoperative peak V O 2 in subjects with non-small-cell lung cancer. This lower aerobic fitness may result from NAC-induced reduction in pulmonary gas exchange or heart toxicity. Since lower fitness is linked to poorer outcome, the decision for NAC may have to be balanced with its possible toxicity.

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Section: Introductionmentioning

confidence: 99%

Preoperative Peak Oxygen Uptake in Lung Cancer Subjects With Neoadjuvant Chemotherapy: A Cross-Sectional Study

et al. 2016

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“…[1,2] In this group, there are no certain criteria regarding the selection of these patients for surgery. However, the generally accepted opinion is that patients who have no findings of N 2 disease and who undergo complete resection benefit the most.…”

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confidence: 99%

Long-term survival results of non-small cell lung cancer patients with complete pathological response after neoadjuvant therapy

Gürsoy¹

2016

Turk Gogus Kalp Dama

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“…W większości badań udawało się w pełni zrealizować zaplanowaną przedoperacyjną chemioterapię, ale jednocześnie wiązała się ona z niewielkim zwiększeniem ryzyka pooperacyjnych powikłań. Zbiorcza analiza 13 badań III fazy opublikowanych do 2010 roku (łącznie 3224 chorych) wykazała, że zastosowanie przedoperacyjnej chemioterapii pozwala uzyskać zmniejszenie względnego ryzyka zgonu o 14% [33].…”

Section: Przedoperacyjna Chemioterapiaunclassified

Rola systemowych metod leczenia u chorych na niedrobnokomórkowego raka płuca i złośliwego międzybłoniaka opłucnej: Uaktualnione zalecenia ekspertów

Jassem

Biernat

Bryl

et al. 2014

Advances in Respiratory Medicine

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Rak płuca jest w Polsce najczęstszą przyczyną zgonów nowotworowych. Około 85% wszystkich nowotworów płuca stanowi rak niedrobnokomórkowy (NDRP), w którym leki cytotoksyczne i ukierunkowane molekularnie odgrywają coraz większą rolę. W pracy przedstawiono oparte na obecnej wiedzy zalecenia dotyczące stosowania tych metod w praktyce klinicznej u chorych na NDRP oraz na złośliwego międzybłoniaka opłucnej.

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Survival Benefit of Neoadjuvant Chemotherapy in Non-small Cell Lung Cancer: An Updated Meta-Analysis of 13 Randomized Control Trials

Abstract: Neoadjuvant chemotherapy, as an addition of surgery, would significantly improve the overall survival of operable NSCLC patients, including patients with stage III NSCLC.

Cited by 197 publications

References 41 publications

Preoperative Peak Oxygen Uptake in Lung Cancer Subjects With Neoadjuvant Chemotherapy: A Cross-Sectional Study

Preoperative Peak Oxygen Uptake in Lung Cancer Subjects With Neoadjuvant Chemotherapy: A Cross-Sectional Study

Long-term survival results of non-small cell lung cancer patients with complete pathological response after neoadjuvant therapy

Rola systemowych metod leczenia u chorych na niedrobnokomórkowego raka płuca i złośliwego międzybłoniaka opłucnej: Uaktualnione zalecenia ekspertów

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