Selection of Therapy Method for Stage III Non Small Cell Lung Cancer after Induction Chemotherapy.

Abstract

It is the main choice that neoadjust chemotherapy following surgery and induction chemotherapy following radiation therapy for locally advanced lung cancer. The aim of this study is to explore the selection of operation or synchronous radiotherapy and chemotherapy for stage III non small cell lung cancer (NSCLC) after induction chemotherapy. After two cycles of induction chemotherapy, patients with stage III NSCLC were divided at random into synchronous radiotherapy and chemotherapy group or operation therapy group for therapy by the chemotherapy effect PR or CR, or estimated complete excision; and patients accepting complete excision operation continuously accepted two cycles of chemotherapy according to original proposal. Total 71 patients with stage III NSCLC entered therapy group after induction chemotherapy. Where, 37 patients accepted synchronous radiotherapy and chemotherapy, and 34 patients accepted operation. The 1-year, 2-year, and 3-year survival rate of synchronous radiotherapy and chemotherapy group was 78.4%, 40.5% and 23.4% respectively, while that of operation group was 81.1%, 39.5% and 35.1% respectively. The medium survival of the two groups was 18.0+/-2.4 and 23.0+/-1.6 respectively, and there was no statistical difference (P=0.23) in survival rate. The disease-free survival rate of synchronous radiotherapy and chemotherapy group and operation group was 14.0+/-1.7 months and 19.0+/-3.2 months respectively (P=0.044), and obviously, there was statistical difference. After induction chemotherapy, patients with stage III NSCLC could select operation therapy and synchronous radiotherapy and chemotherapy. Where, synchronous radiotherapy and chemotherapy is relatively safe, but the adverse reaction can't be ignored. Operation therapy has higher risk and difficulty for induction chemotherapy, but has shown its superiority in disease-free survival.