Author of

• 14451

  +

  P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Locoregional Disease – NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 14467

    +

    P2.03-016 - Comparing Outcomes of Neoadjuvant and Adjuvant Chemotherapy in Non-Small Cell Lung Cancer (ID 3130)

    09:30 - 09:30  |  Author(s): A. Bista
    • Abstract

    Background:
    Lung Cancer is the most common cancer in the US, and the leading cause of cancer deaths. Patient with Non-Small Cell lung cancer (NSCLC) are at substantial risk for recurrence and death even after complete surgical resection, and hence there is rationale for the use of chemotherapy and/or radiation therapy. Cisplatin based regimen is recommended. Adjuvant chemotherapy is most preferred treatment in patients with resectable disease. However, the role of neoadjuvant therapy is unclear. The purpose of this study was to compare the outcome of neoadjuvant and adjuvant chemotherapy in resectable NSCLC. The primary objective was to compare the observed and progression free survival. Secondary objective was to analyze the factors associated with better outcomes in both groups.
    
    Methods:
    This is a retrospective study conducted at a community based teaching hospital after IRB approval. A total of 117 patients diagnosed with NSCLC Stage 2 and 3, treated with either adjuvant or neoadjuvant chemotherapy, in addition to surgery, from 2001 to 2013 were included in the study. Chemotherapy consisted of cisplatin based regimen. The patients were followed to a maximum of 5 years. Median follow up period was 31 months. Overall survival and progression free survival was calculated using Kaplan Meyer Curve and compared using Log rank test.
    
    Results:
    Median age of diagnosis was 66 years. 26.4% of the patients were in neoadjuvant group. Mean 5 year overall survival was found to be better in neoadjuvant group (80.3%) when compared to adjuvant group (54.7%) with p value of 0.314. Mean 5 year progression free survival was better in neoadjuvant group (63.5%) when compared to adjuvant group (33.6%) with p value of 0.234. As the demographic profile for the patients were not comparable, five year overall survival after adjusting for age, sex and stage at diagnosis was compared using COX proportionate hazard model. This was found to be significantly better for neoadjuvant group compared to adjuvant group with HR of 0.374, 95% CI of 0.152 to 0.919; p value of 0.032. Figure 1
    
    
    
    Conclusion:
    Overall survival and progression free survival was found to be better in neoadjuvant group, but it was not statistically significant. However, when adjusted for age, sex and stage at diagnosis survival was statistically significant in neoadjuvant group. This study suggests a trend in overall and progression free survival benefit in neoadjuvant group. Further large population randomized trials would be needed to confirm the survival benefit seen in this small retrospective study.