Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of southwest oncology group trial 9416 (Intergroup Trial 0160)

Valerie W. Rusch, Dorothy J. Giroux, Michael J. Kraut, John Crowley, Mark Hazuka, David Johnson, Melvyn Goldberg, Frank Detterbeck, Frances Shepherd, Ronald Burkes, Timothy Winton, Claude Deschamps, Robert Livingston, David R Gandara

Research output: Contribution to journalArticle

220 Citations (Scopus)

Abstract

Objective: The rate of complete resection (50%) and the 5-year survival (30%) for non-small cell lung carcinomas of the superior sulcus have not changed for 40 years. Recently, combined modality therapy has improved outcome in other subsets of locally advanced non-small cell lung carcinoma. This trial tested the feasibility of induction chemoradiation and surgical resection in non-small cell lung carcinoma of the superior sulcus with the ultimate aim of improving resectability and survival. Methods: Patients with mediastinoscopy-negative T3-4 N0-1 superior sulcus non-small cell lung carcinoma received 2 cycles of cisplatin and etoposide chemotherapy concurrent with 45 Gy of radiation. Patients with stable or responding disease underwent thoracotomy 3 to 5 weeks later. All patients received 2 more cycles of chemotherapy and were followed up by serial radiographs and scans. Survival was calculated by the Kaplan-Meier method and prognostic factors were assessed for significance by Cox regression analysis. Results: From April 1995 to September 1999, 111 eligible patients (77 men, 34 women) were entered in the study, including 80 (72.1%) with T3 and 31 with T4 tumors. Induction therapy was completed as planned in 102 (92%) patients. There were 3 treatment-related deaths (2.7%). Cytopenia was the main grade 3 to 4 toxicity. Of 95 patients eligible for surgery, 83 underwent thoracotomy, 2 (2.4%) died postoperatively, and 76 (92%) had a complete resection. Fifty-four (65%) thoracotomy specimens showed either a pathologic complete response or minimal microscopic disease. The 2-year survival was 55% for all eligible patients and 70% for patients who had a complete resection. To date, survival is not significantly influenced by patient sex, T status, or pathologic response. Conclusions: (1) This combined modality treatment is feasible in a multi-institutional setting; (2) the pathologic complete response rates were high; and (3) resectability and overall survival were improved compared with historical experience, especially for T4 tumors, which usually have a grim prognosis.

Original languageEnglish (US)
Pages (from-to)472-483
Number of pages12
JournalJournal of Thoracic and Cardiovascular Surgery
Volume121
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Non-Small Cell Lung Carcinoma
Survival
Thoracotomy
Mediastinoscopy
Radiation Dosage
Drug Therapy
Combined Modality Therapy
Etoposide
Cisplatin
Neoplasms
Therapeutics
Regression Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus : Initial results of southwest oncology group trial 9416 (Intergroup Trial 0160). / Rusch, Valerie W.; Giroux, Dorothy J.; Kraut, Michael J.; Crowley, John; Hazuka, Mark; Johnson, David; Goldberg, Melvyn; Detterbeck, Frank; Shepherd, Frances; Burkes, Ronald; Winton, Timothy; Deschamps, Claude; Livingston, Robert; Gandara, David R.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 121, No. 3, 2001, p. 472-483.

Research output: Contribution to journalArticle

Rusch, VW, Giroux, DJ, Kraut, MJ, Crowley, J, Hazuka, M, Johnson, D, Goldberg, M, Detterbeck, F, Shepherd, F, Burkes, R, Winton, T, Deschamps, C, Livingston, R & Gandara, DR 2001, 'Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of southwest oncology group trial 9416 (Intergroup Trial 0160)', Journal of Thoracic and Cardiovascular Surgery, vol. 121, no. 3, pp. 472-483. https://doi.org/10.1067/mtc.2001.112465
Rusch, Valerie W. ; Giroux, Dorothy J. ; Kraut, Michael J. ; Crowley, John ; Hazuka, Mark ; Johnson, David ; Goldberg, Melvyn ; Detterbeck, Frank ; Shepherd, Frances ; Burkes, Ronald ; Winton, Timothy ; Deschamps, Claude ; Livingston, Robert ; Gandara, David R. / Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus : Initial results of southwest oncology group trial 9416 (Intergroup Trial 0160). In: Journal of Thoracic and Cardiovascular Surgery. 2001 ; Vol. 121, No. 3. pp. 472-483.
@article{598fe8ada8fb40509082491e639cb5a9,
title = "Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of southwest oncology group trial 9416 (Intergroup Trial 0160)",
abstract = "Objective: The rate of complete resection (50{\%}) and the 5-year survival (30{\%}) for non-small cell lung carcinomas of the superior sulcus have not changed for 40 years. Recently, combined modality therapy has improved outcome in other subsets of locally advanced non-small cell lung carcinoma. This trial tested the feasibility of induction chemoradiation and surgical resection in non-small cell lung carcinoma of the superior sulcus with the ultimate aim of improving resectability and survival. Methods: Patients with mediastinoscopy-negative T3-4 N0-1 superior sulcus non-small cell lung carcinoma received 2 cycles of cisplatin and etoposide chemotherapy concurrent with 45 Gy of radiation. Patients with stable or responding disease underwent thoracotomy 3 to 5 weeks later. All patients received 2 more cycles of chemotherapy and were followed up by serial radiographs and scans. Survival was calculated by the Kaplan-Meier method and prognostic factors were assessed for significance by Cox regression analysis. Results: From April 1995 to September 1999, 111 eligible patients (77 men, 34 women) were entered in the study, including 80 (72.1{\%}) with T3 and 31 with T4 tumors. Induction therapy was completed as planned in 102 (92{\%}) patients. There were 3 treatment-related deaths (2.7{\%}). Cytopenia was the main grade 3 to 4 toxicity. Of 95 patients eligible for surgery, 83 underwent thoracotomy, 2 (2.4{\%}) died postoperatively, and 76 (92{\%}) had a complete resection. Fifty-four (65{\%}) thoracotomy specimens showed either a pathologic complete response or minimal microscopic disease. The 2-year survival was 55{\%} for all eligible patients and 70{\%} for patients who had a complete resection. To date, survival is not significantly influenced by patient sex, T status, or pathologic response. Conclusions: (1) This combined modality treatment is feasible in a multi-institutional setting; (2) the pathologic complete response rates were high; and (3) resectability and overall survival were improved compared with historical experience, especially for T4 tumors, which usually have a grim prognosis.",
author = "Rusch, {Valerie W.} and Giroux, {Dorothy J.} and Kraut, {Michael J.} and John Crowley and Mark Hazuka and David Johnson and Melvyn Goldberg and Frank Detterbeck and Frances Shepherd and Ronald Burkes and Timothy Winton and Claude Deschamps and Robert Livingston and Gandara, {David R}",
year = "2001",
doi = "10.1067/mtc.2001.112465",
language = "English (US)",
volume = "121",
pages = "472--483",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus

T2 - Initial results of southwest oncology group trial 9416 (Intergroup Trial 0160)

AU - Rusch, Valerie W.

AU - Giroux, Dorothy J.

AU - Kraut, Michael J.

AU - Crowley, John

AU - Hazuka, Mark

AU - Johnson, David

AU - Goldberg, Melvyn

AU - Detterbeck, Frank

AU - Shepherd, Frances

AU - Burkes, Ronald

AU - Winton, Timothy

AU - Deschamps, Claude

AU - Livingston, Robert

AU - Gandara, David R

PY - 2001

Y1 - 2001

N2 - Objective: The rate of complete resection (50%) and the 5-year survival (30%) for non-small cell lung carcinomas of the superior sulcus have not changed for 40 years. Recently, combined modality therapy has improved outcome in other subsets of locally advanced non-small cell lung carcinoma. This trial tested the feasibility of induction chemoradiation and surgical resection in non-small cell lung carcinoma of the superior sulcus with the ultimate aim of improving resectability and survival. Methods: Patients with mediastinoscopy-negative T3-4 N0-1 superior sulcus non-small cell lung carcinoma received 2 cycles of cisplatin and etoposide chemotherapy concurrent with 45 Gy of radiation. Patients with stable or responding disease underwent thoracotomy 3 to 5 weeks later. All patients received 2 more cycles of chemotherapy and were followed up by serial radiographs and scans. Survival was calculated by the Kaplan-Meier method and prognostic factors were assessed for significance by Cox regression analysis. Results: From April 1995 to September 1999, 111 eligible patients (77 men, 34 women) were entered in the study, including 80 (72.1%) with T3 and 31 with T4 tumors. Induction therapy was completed as planned in 102 (92%) patients. There were 3 treatment-related deaths (2.7%). Cytopenia was the main grade 3 to 4 toxicity. Of 95 patients eligible for surgery, 83 underwent thoracotomy, 2 (2.4%) died postoperatively, and 76 (92%) had a complete resection. Fifty-four (65%) thoracotomy specimens showed either a pathologic complete response or minimal microscopic disease. The 2-year survival was 55% for all eligible patients and 70% for patients who had a complete resection. To date, survival is not significantly influenced by patient sex, T status, or pathologic response. Conclusions: (1) This combined modality treatment is feasible in a multi-institutional setting; (2) the pathologic complete response rates were high; and (3) resectability and overall survival were improved compared with historical experience, especially for T4 tumors, which usually have a grim prognosis.

AB - Objective: The rate of complete resection (50%) and the 5-year survival (30%) for non-small cell lung carcinomas of the superior sulcus have not changed for 40 years. Recently, combined modality therapy has improved outcome in other subsets of locally advanced non-small cell lung carcinoma. This trial tested the feasibility of induction chemoradiation and surgical resection in non-small cell lung carcinoma of the superior sulcus with the ultimate aim of improving resectability and survival. Methods: Patients with mediastinoscopy-negative T3-4 N0-1 superior sulcus non-small cell lung carcinoma received 2 cycles of cisplatin and etoposide chemotherapy concurrent with 45 Gy of radiation. Patients with stable or responding disease underwent thoracotomy 3 to 5 weeks later. All patients received 2 more cycles of chemotherapy and were followed up by serial radiographs and scans. Survival was calculated by the Kaplan-Meier method and prognostic factors were assessed for significance by Cox regression analysis. Results: From April 1995 to September 1999, 111 eligible patients (77 men, 34 women) were entered in the study, including 80 (72.1%) with T3 and 31 with T4 tumors. Induction therapy was completed as planned in 102 (92%) patients. There were 3 treatment-related deaths (2.7%). Cytopenia was the main grade 3 to 4 toxicity. Of 95 patients eligible for surgery, 83 underwent thoracotomy, 2 (2.4%) died postoperatively, and 76 (92%) had a complete resection. Fifty-four (65%) thoracotomy specimens showed either a pathologic complete response or minimal microscopic disease. The 2-year survival was 55% for all eligible patients and 70% for patients who had a complete resection. To date, survival is not significantly influenced by patient sex, T status, or pathologic response. Conclusions: (1) This combined modality treatment is feasible in a multi-institutional setting; (2) the pathologic complete response rates were high; and (3) resectability and overall survival were improved compared with historical experience, especially for T4 tumors, which usually have a grim prognosis.

UR - http://www.scopus.com/inward/record.url?scp=17744391075&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17744391075&partnerID=8YFLogxK

U2 - 10.1067/mtc.2001.112465

DO - 10.1067/mtc.2001.112465

M3 - Article

C2 - 11241082

AN - SCOPUS:17744391075

VL - 121

SP - 472

EP - 483

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 3

ER -