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2024 World Conference on Lung Cancer (WCLC) - ePos ...
EP.08D.10 Outcome after Preoperative Chemoradiothe ...
EP.08D.10 Outcome after Preoperative Chemoradiotherapy for Non-Small Cell Lung Cancer with Chest Wall Invasion
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This study, conducted by the Department of Thoracic Surgery at the National Cancer Center East Hospital, examines the outcomes of preoperative chemoradiotherapy (CRT) in treating non-small cell lung cancer (NSCLC) with chest wall invasion (CWI), excluding superior sulcus tumors (SST). The study aims to clarify the effectiveness of CRT followed by surgery versus upfront surgery (UFS).<br /><br />The analysis included 70 patients with NSCLC CWI. These patients were divided into two groups: one underwent CRT before surgery, and the other underwent UFS. The CRT regimen included chemotherapy (CDDPVNR or CBDCAPTX) and radiotherapy (RT) with 45 Gy. Results indicated that the preoperative CRT group had better overall survival and a lower recurrence rate than the UFS group. In the CRT group, 25% of the cases were classified as Ef3, indicative of a more effective treatment response. In contrast, only 26% of the UFS group received any adjuvant therapy. <br /><br />However, there are several potential biases and limitations within the study, including the younger age and better performance status of patients in the CRT group, the higher number of cN0 cases in this group, as well as the study being single-centered, retrospective, and having a small sample size.<br /><br />Despite these limitations, the researchers concluded that CRT offers a better prognosis than UFS for patients with NSCLC CWI (excluding SST). Yet, the comparison with neoadjuvant nivolumab remains an open question, highlighting the need for future prospective studies to further evaluate the efficacy and safety of preoperative treatments in this patient category. A survey of 46 institutions in Japan also indicated varied treatment approaches for NSCLC with CWI, with CRT being one of the common choices.
Asset Subtitle
Yutaro Koike
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Speaker
Yutaro Koike
Topic
Local-Regional Non-small Cell Lung Cancer
Keywords
preoperative chemoradiotherapy
non-small cell lung cancer
chest wall invasion
superior sulcus tumors
surgery outcomes
overall survival
treatment response
study limitations
neoadjuvant nivolumab
prospective studies
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