Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer

Mature results of Southwest Oncology Group Phase II Study 8805

K. S. Albain, V. W. Rusch, J. J. Crowley, T. W. Rice, A. T. Turrisi, J. K. Weick, V. A. Lonchyna, C. A. Presant, R. J. McKenna, David R Gandara, H. Fosmire, S. A. Taylor, K. J. Stelzer, K. R. Beasley, R. B. Livingston

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the feasibility of concurrent chemotherapy and irradiation (chemoRT) followed by surgery in locally advanced non-small-cell lung cancer (NSCLC) in a cooperative group setting, and to estimate response, resection rates, relapse patterns, and survival for stage subsets IIIA(N2) versus IIIB. Patients and Methods: Biopsy proof of either positive N2 nodes (IIIAN2) or of N3 nodes or T4 primary lesions (IIIB) was required. Induction was two cycles of cisplatin and etoposide plus concurrent chest RT to 45 Gy. Resection was attempted if response or stable disease occurred. A chemoRT boost was given if either unresectable disease or positive margins or nodes was found. Results: The median follow-up time for 126 eligible patients [75 stage IIIA(N2) and 51 IIIB] was 2.4 years. The objective response rate to induction was 59%, and 29% were stable. Resectability was 85% for the IIIA(N2) group eligible for surgery and 80% for the IIIB group. Reversible grade 4 toxicity occurred in 13% of patients. There were 13 treatment- related deaths (10%) and 19 others (15%) died of causes not related to toxicity or tumor. Of 65 relapses, 11% were only locoregional and 61% were only distant. There were 26 brain relapses, of which 19 were the sole site or cause of death. There was no survival difference (P = .81) between stage IIIA(N2) versus stage IIIB (median survivals, 13 and 17 months; 2-year survival rates, 37% and 39%; 3-year survival rates, 27% and 24%). The stongest predictor of long-term survival after thoracotomy was absence of tumor in the mediastinal nodes at surgery (median survivals, 30 v 10 months; 3-year survival rates, 44% v 18%; P = .0005). Conclusion: This trimodality approach was feasible in this Southwest Oncology Group (SWAG) study, with an encouraging 26% 3-year survival rate. An Intergroup study is currently being conducted to determine whether surgery adds more to the risk or to the benefit of chemoRT.

Original languageEnglish (US)
Pages (from-to)1880-1892
Number of pages13
JournalJournal of Clinical Oncology
Volume13
Issue number8
StatePublished - 1995
Externally publishedYes

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Etoposide
Non-Small Cell Lung Carcinoma
Cisplatin
Radiotherapy
Thorax
Survival Rate
Survival
Recurrence
Thoracotomy
Cause of Death
Neoplasms
Biopsy
Drug Therapy
Brain

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer : Mature results of Southwest Oncology Group Phase II Study 8805. / Albain, K. S.; Rusch, V. W.; Crowley, J. J.; Rice, T. W.; Turrisi, A. T.; Weick, J. K.; Lonchyna, V. A.; Presant, C. A.; McKenna, R. J.; Gandara, David R; Fosmire, H.; Taylor, S. A.; Stelzer, K. J.; Beasley, K. R.; Livingston, R. B.

In: Journal of Clinical Oncology, Vol. 13, No. 8, 1995, p. 1880-1892.

Research output: Contribution to journalArticle

Albain, KS, Rusch, VW, Crowley, JJ, Rice, TW, Turrisi, AT, Weick, JK, Lonchyna, VA, Presant, CA, McKenna, RJ, Gandara, DR, Fosmire, H, Taylor, SA, Stelzer, KJ, Beasley, KR & Livingston, RB 1995, 'Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer: Mature results of Southwest Oncology Group Phase II Study 8805', Journal of Clinical Oncology, vol. 13, no. 8, pp. 1880-1892.
Albain, K. S. ; Rusch, V. W. ; Crowley, J. J. ; Rice, T. W. ; Turrisi, A. T. ; Weick, J. K. ; Lonchyna, V. A. ; Presant, C. A. ; McKenna, R. J. ; Gandara, David R ; Fosmire, H. ; Taylor, S. A. ; Stelzer, K. J. ; Beasley, K. R. ; Livingston, R. B. / Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer : Mature results of Southwest Oncology Group Phase II Study 8805. In: Journal of Clinical Oncology. 1995 ; Vol. 13, No. 8. pp. 1880-1892.
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title = "Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer: Mature results of Southwest Oncology Group Phase II Study 8805",
abstract = "Purpose: To assess the feasibility of concurrent chemotherapy and irradiation (chemoRT) followed by surgery in locally advanced non-small-cell lung cancer (NSCLC) in a cooperative group setting, and to estimate response, resection rates, relapse patterns, and survival for stage subsets IIIA(N2) versus IIIB. Patients and Methods: Biopsy proof of either positive N2 nodes (IIIAN2) or of N3 nodes or T4 primary lesions (IIIB) was required. Induction was two cycles of cisplatin and etoposide plus concurrent chest RT to 45 Gy. Resection was attempted if response or stable disease occurred. A chemoRT boost was given if either unresectable disease or positive margins or nodes was found. Results: The median follow-up time for 126 eligible patients [75 stage IIIA(N2) and 51 IIIB] was 2.4 years. The objective response rate to induction was 59{\%}, and 29{\%} were stable. Resectability was 85{\%} for the IIIA(N2) group eligible for surgery and 80{\%} for the IIIB group. Reversible grade 4 toxicity occurred in 13{\%} of patients. There were 13 treatment- related deaths (10{\%}) and 19 others (15{\%}) died of causes not related to toxicity or tumor. Of 65 relapses, 11{\%} were only locoregional and 61{\%} were only distant. There were 26 brain relapses, of which 19 were the sole site or cause of death. There was no survival difference (P = .81) between stage IIIA(N2) versus stage IIIB (median survivals, 13 and 17 months; 2-year survival rates, 37{\%} and 39{\%}; 3-year survival rates, 27{\%} and 24{\%}). The stongest predictor of long-term survival after thoracotomy was absence of tumor in the mediastinal nodes at surgery (median survivals, 30 v 10 months; 3-year survival rates, 44{\%} v 18{\%}; P = .0005). Conclusion: This trimodality approach was feasible in this Southwest Oncology Group (SWAG) study, with an encouraging 26{\%} 3-year survival rate. An Intergroup study is currently being conducted to determine whether surgery adds more to the risk or to the benefit of chemoRT.",
author = "Albain, {K. S.} and Rusch, {V. W.} and Crowley, {J. J.} and Rice, {T. W.} and Turrisi, {A. T.} and Weick, {J. K.} and Lonchyna, {V. A.} and Presant, {C. A.} and McKenna, {R. J.} and Gandara, {David R} and H. Fosmire and Taylor, {S. A.} and Stelzer, {K. J.} and Beasley, {K. R.} and Livingston, {R. B.}",
year = "1995",
language = "English (US)",
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TY - JOUR

T1 - Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer

T2 - Mature results of Southwest Oncology Group Phase II Study 8805

AU - Albain, K. S.

AU - Rusch, V. W.

AU - Crowley, J. J.

AU - Rice, T. W.

AU - Turrisi, A. T.

AU - Weick, J. K.

AU - Lonchyna, V. A.

AU - Presant, C. A.

AU - McKenna, R. J.

AU - Gandara, David R

AU - Fosmire, H.

AU - Taylor, S. A.

AU - Stelzer, K. J.

AU - Beasley, K. R.

AU - Livingston, R. B.

PY - 1995

Y1 - 1995

N2 - Purpose: To assess the feasibility of concurrent chemotherapy and irradiation (chemoRT) followed by surgery in locally advanced non-small-cell lung cancer (NSCLC) in a cooperative group setting, and to estimate response, resection rates, relapse patterns, and survival for stage subsets IIIA(N2) versus IIIB. Patients and Methods: Biopsy proof of either positive N2 nodes (IIIAN2) or of N3 nodes or T4 primary lesions (IIIB) was required. Induction was two cycles of cisplatin and etoposide plus concurrent chest RT to 45 Gy. Resection was attempted if response or stable disease occurred. A chemoRT boost was given if either unresectable disease or positive margins or nodes was found. Results: The median follow-up time for 126 eligible patients [75 stage IIIA(N2) and 51 IIIB] was 2.4 years. The objective response rate to induction was 59%, and 29% were stable. Resectability was 85% for the IIIA(N2) group eligible for surgery and 80% for the IIIB group. Reversible grade 4 toxicity occurred in 13% of patients. There were 13 treatment- related deaths (10%) and 19 others (15%) died of causes not related to toxicity or tumor. Of 65 relapses, 11% were only locoregional and 61% were only distant. There were 26 brain relapses, of which 19 were the sole site or cause of death. There was no survival difference (P = .81) between stage IIIA(N2) versus stage IIIB (median survivals, 13 and 17 months; 2-year survival rates, 37% and 39%; 3-year survival rates, 27% and 24%). The stongest predictor of long-term survival after thoracotomy was absence of tumor in the mediastinal nodes at surgery (median survivals, 30 v 10 months; 3-year survival rates, 44% v 18%; P = .0005). Conclusion: This trimodality approach was feasible in this Southwest Oncology Group (SWAG) study, with an encouraging 26% 3-year survival rate. An Intergroup study is currently being conducted to determine whether surgery adds more to the risk or to the benefit of chemoRT.

AB - Purpose: To assess the feasibility of concurrent chemotherapy and irradiation (chemoRT) followed by surgery in locally advanced non-small-cell lung cancer (NSCLC) in a cooperative group setting, and to estimate response, resection rates, relapse patterns, and survival for stage subsets IIIA(N2) versus IIIB. Patients and Methods: Biopsy proof of either positive N2 nodes (IIIAN2) or of N3 nodes or T4 primary lesions (IIIB) was required. Induction was two cycles of cisplatin and etoposide plus concurrent chest RT to 45 Gy. Resection was attempted if response or stable disease occurred. A chemoRT boost was given if either unresectable disease or positive margins or nodes was found. Results: The median follow-up time for 126 eligible patients [75 stage IIIA(N2) and 51 IIIB] was 2.4 years. The objective response rate to induction was 59%, and 29% were stable. Resectability was 85% for the IIIA(N2) group eligible for surgery and 80% for the IIIB group. Reversible grade 4 toxicity occurred in 13% of patients. There were 13 treatment- related deaths (10%) and 19 others (15%) died of causes not related to toxicity or tumor. Of 65 relapses, 11% were only locoregional and 61% were only distant. There were 26 brain relapses, of which 19 were the sole site or cause of death. There was no survival difference (P = .81) between stage IIIA(N2) versus stage IIIB (median survivals, 13 and 17 months; 2-year survival rates, 37% and 39%; 3-year survival rates, 27% and 24%). The stongest predictor of long-term survival after thoracotomy was absence of tumor in the mediastinal nodes at surgery (median survivals, 30 v 10 months; 3-year survival rates, 44% v 18%; P = .0005). Conclusion: This trimodality approach was feasible in this Southwest Oncology Group (SWAG) study, with an encouraging 26% 3-year survival rate. An Intergroup study is currently being conducted to determine whether surgery adds more to the risk or to the benefit of chemoRT.

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