Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11611

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    P2.07-016 - Perioperative nutrition of induction chemoradiotherapy followed by surgery in locally advanced non-small lung cancer patients (ID 1411)

    09:30 - 09:30  |  Author(s): M. Hayama
    • Abstract

    Background
    Induction chemoradiotherapy (CRT) followed by surgery (iCRT) is one of treatment strategies for locally advanced non-small cell lung cancers (NSCLCs). We have previously reported its feasibility and good clinical outcome with approximately 60% of 5-year overall survival rate. .Perioperative nutritional status,is considered as one of important factors for improved clinical outcome after surgery and other treatments. Here, we investigated the perioperative nutritional status in NSCLC patients treated by iCRT (CRT group) to evaluate the influence of nutritional variables on clinical outcome by comparing that in NSCLC patients with simple pulmonary resection without CRT (non-CRT group) .

    Methods
    Thirty-three consecutive patients with locally adcanced NSCLC who underwent iCRT from January 1, 2009, until December 31, 2011 at our institute were included in this study. The regimen of CRT was two cycles of docetaxel (40 mg/m[2]) plus cisplatin (40 mg/m[2]) with concurrent radiotherapy (46 gray) and the surgery was performed within 6 weeks of completing induction CRT. We compared nutrition-related factors and clinical outcome in 33 iCRT patients with those in 58 consecutive NSCLC patients who underwent lobectomy during January 1 to December 31, 2011 at out institute. .As for blood nutritional factors, total lymphocyte count (TLC), albumin (Alb), total cholesterol (T-cho), choline esterase (ChE), were examined. The prognostic nutritional index (PNI) was also calculated by Alb and TLC. Each nutrition-relatd factors were examined 1) before CRT, 2) before surgery and 3) one month after surgery.

    Results
    Median age of CRT group (61 years old) was significantly younger than that of non-CRT group (69 years old). Twenty-one males and 12 females and 44 males and 14 females were enrolled in CRT and non-CRT groups, respectively. Before any treatment, no significant difference was observed in body mass index and any blood nutritional factors in both groups. After induction CRT, TLC was significantly decreased, and additionally, Alb, T-cho, and ChE were significantly decreased after surgery comparing with those before surgery (after CRT). As for preoperative status in both groups, TLC, Alb and PNI were significantly lower in CRT group than in non-CRT group. Regard with surgery, extended surgery, operating time, and blood loss was significantly heavier in CRT group than in non-CRT group. Perioperative mortality rate was 0% in both groups and the frequency of post-operative complication was similar in both groups (51% and 41% in CRT and non-CRT groups, respectively). The length of hospital stay after surgery was significantly longer in CRT group (median 23 days) than in non-CRT group (median 14 days). Among CRT group, patients with loiw PNI index could not administrate adjuvant chemotherapy.

    Conclusion
    Perioperative nutritional status, especially TLC, is suppressed after CRT and moreover after surgery. Suppression of nutritional status continued one month after surgery with induction CRT and severe suppression of nutritional status disturbs further treatment such as adjuvant chemotherapy.