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V.R. Litle



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    P1.05 - Early Stage NSCLC (ID 691)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-013 - Induction Chemoradiation Is Associated with Improved Survival in Resected Non-Pancoast Lung Cancer with Chest Wall Invasion (ID 8862)

      09:30 - 09:30  |  Author(s): V.R. Litle

      • Abstract

      Background:
      Induction chemo-radiation therapy has shown an increase in 5-year survival in patients with superior sulcus tumors and complete surgical resection. We hypothesized that induction chemo-radiation therapy followed by surgical resection is associated with improved survival in patients with non-superior sulcus lung cancer with chest wall invasion.

      Method:
      We performed a retrospective review of a single institution database (1/1/1992-1/31/17) of T3 (chest wall invasion) N0/N1 patients with non-small cell lung cancer who underwent surgical resection. Exclusion criteria included 1) superior sulcus tumors and 2) resection performed for palliation or recurrence. Statistical analysis was performed using Kruskal-Wallis test (disease free times), and Kaplan-Meier curves.

      Result:
      Thirty-four patients were included in the analysis. Median age was 63.5 (range 37-84). By clinical stage, 31(91%) were IIB(T3N0) and 3(9%) were IIIA(T3N1). By histology, 15 were adenocarcinomas, 11 squamous and 8 large cell. Five-year overall survival (OS) was 30% for the entire cohort. Of the 34 patients, 16(47%) received induction chemo-radiation (platinum-based doublet and radiation dose 59-61 Gy) before surgery, and the remaining 18(53%) underwent surgery as the first treatment. Three patients belonging to the no-induction group died within 30 days after initial surgical treatment and were excluded from analysis. In the remaining 31 patients, induction chemo-radiation was associated with improved 5-year OS (53% for induction group vs 7% for no-induction group; p<0.01; Figure). Disease recurrence was evident in 10 cases, 3 in the induction group and 7 in the no-induction group (median disease-free time 94.6 months vs. 14.0 among the no-induction group; p<0.01). R1 resection status was observed in 6 patients, 5 of them in the no-induction group. Figure 1



      Conclusion:
      In patients with non-superior sulcus lung cancers with chest wall invasion, induction chemo-radiation therapy followed by surgical resection is associated with decreased recurrence. More importantly, induction chemo-radiation is associated with improved overall survival in this population.