ving Induction Radiation in Addition to Chemotherap ot Associated with Improved Survival of NSCLC Patie with Operable Mediastinal Nodal Disease Chi-Fu Jeffrey Yang MD, Brian Gulack MD, Paul Speicher MD, Xiaofei Wang PhD, Mark Onaitis MD, David Harpole MD, Thomas D’Amico MD, Mark Berry MD, Matthew Hartwig MD Duke Cancer Institute Durham, NC
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Giving Induction Radiation in Addition to Chemotherapy Is Not Associated with Improved Survival of NSCLC Patients with Operable Mediastinal Nodal Disease.
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Giving Induction Radiation in Addition to Chemotherapy Is Not Associated with Improved Survival of NSCLC Patients
with Operable Mediastinal Nodal Disease
Chi-Fu Jeffrey Yang MD, Brian Gulack MD, Paul Speicher MD, Xiaofei Wang PhD, Mark Onaitis MD, David Harpole MD, Thomas D’Amico MD, Mark Berry MD,
Matthew Hartwig MD
Duke Cancer InstituteDurham, NC
Disclosures
Dr. Thomas D’Amico is a consultant for Scanlan
No conflicts related to this presentation
Introduction For patients selected for surgery for stage IIIA-N2
non-small cell lung cancer (NSCLC), the optimal induction therapy strategy is not well-established1
1. J Natl Compr Canc Netw 2012; 10: 599-613
Introduction For patients selected for surgery for stage IIIA-N2
non-small cell lung cancer (NSCLC), the optimal induction therapy strategy is not well-established1
Few prospective studies have evaluated induction therapy regimens
1. J Natl Compr Canc Netw 2012; 10: 599-613
Introduction For patients selected for surgery for stage IIIA-N2
non-small cell lung cancer (NSCLC), the optimal induction therapy strategy is not well-established1
Few prospective studies have evaluated induction therapy regimens
Previous studies have shown that the addition of radiation to chemotherapy enhances mediastinal nodal down-staging but does not improve survival when compared to induction chemotherapy alone2
No histologic verification of N2 disease prior to induction therapy
No data on type of N2 disease (multi-station vs single station)
Survival was not cancer-specific and no data on location of recurrence
Summary No significant differences in perioperative
mortality between induction chemotherapy and induction chemoradiation
Summary No significant differences in perioperative
mortality between induction chemotherapy and induction chemoradiation
Induction chemoradiation was associated with a higher rate of primary tumor (T) and mediastinal nodal down-staging
However, there was no survival benefit associated with addition of radiation to induction chemotherapy
Conclusion
The addition of radiation to induction chemotherapy for operable stage IIIA-N2 NSCLC is not associated with a significant improvement in overall survival
Conclusion
The addition of radiation to induction chemotherapy for operable stage IIIA-N2 NSCLC is not associated with a significant improvement in overall survival
The use of induction chemoradiation should be reexamined in the context of randomized trials
Conclusion
The addition of radiation to induction chemotherapy for operable stage IIIA-N2 NSCLC is not associated with a significant improvement in overall survival
The use of induction chemoradiation should be reexamined in the context of randomized trials
Future studies should focus on identifying characteristics that can be used to indicate if and when radiation is needed in addition to chemotherapy