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J. Yang



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    P3.08 - Locally Advanced Nsclc (ID 724)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Locally Advanced NSCLC
    • Presentations: 1
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      P3.08-003 - Multimodal Treatment in the Initially Inoperable Stage III N2 Non-Small Cell Lung Cancer Patients (ID 10088)

      09:30 - 09:30  |  Author(s): J. Yang

      • Abstract

      Background:
      A multimodal treatment is frequently performed in many initially inoperable stage III N2 non-small cell lung cancer. However, selection of the best treatment for these patients is controversial issue. This study was conducted to explore the benefit of neoadjuvant chemotherapy and adjuvant therapy in these patients.

      Method:
      Between Jan. 2008 and Dec. 2015, patients with stage III N2 NSCLC enrolled. All of them were treated with induction chemotherapy and surgical resection. Some of them who had high risk factors for disease recurrence underwent adjuvant treatment including chemothearpy, radiothearpy or concurrent chemoradiotherapy.We reviewed medical record including clinicopathologic characteristics and the survival outcome.

      Result:
      The median age was 65 (range 43-77), and male was more common (M:F, 3.8:1). Median follow-up period was 23.6 months (Range: 3.0-23.6 months). 32 patients (59.%) presented with squamous cell cancer (SqCC), and 20 patients (37.0%) were presented as adenocarcinoma. Docetaxel/cisplatin in 52 patients (96.3%) and gemcitabine/cisplatin in 2 patients (3.7%) were selected as neoadjuvant chemotherapy regimen. The overall clinical response rate to induction chemotherapy was 70.4%. After surgical resection, 27 patients (50.0%) underwent adjuvant chemotherapy alone and 20 patients (37.0%) underwent adjuvant radiotherapy with or without chemotherapy. Median OS was 56.4 months (range 33.5-79.3 months) and median PFS was 24.4 months (ranage 26.6-43.0 months). In multivariable analysis, the adjuvant treatment group showed better survival than the no adjuvant treatment group. Among them, median OS was not reached in adjuvant radiotherapy with or without chemotherapy group and 53.9 months in the adjuvnat chemotherapy alone group (p=0.016).

      Conclusion:
      Neoadjuvant chemotherapy is active in patients with stage III N2 NSCLC and adjuvant multimodal therapy including chemotherapy or radiotherapy demonstrated favorable survival outcomes. Based on our data, active multimodal neoadjuvant and postadjuvant treatment should be considered for the initially unoperable stage III N2 NSCLC patients.