Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers: Report of Japan clinical oncology group trial 9806

Hideo Kunitoh, Harubumi Kato, Masahiro Tsuboi, Taro Shibata, Hisao Asamura, Yukito Ichonose, Nobuyuki Katakami, Kanji Nagai, Tetsuya Mitsudomi, Akihide Matsumura, Ken Nakagawa, Hirohito Tada, Nagahiro Saijo

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Abstract

Purpose: To evaluate the safety and efficacy of preoperative chemoradiotherapy followed by surgical resection for superior sulcus tumors (SSTs). Patients and Methods: Patients with pathologically documented non-small-cell lung cancer with invasion of the first rib or more superior chest wall were enrolled as eligible; those with distant metastasis, pleural dissemination, and/or mediastinal node involvement were excluded. Patients received two cycles of chemotherapy every 4 weeks as follows; mitomycin 8 mg/m2 on day 1, vindesine 3 mg/m2 on days 1 and 8, and cisplatin 80 mg/m2 on day 1. Radiotherapy directed at the tumor and the ipsilateral supraclavicular nodes was started on day 2 of each course, at the total dose of 45 Gy in 25 fractions, with a 1-week split. Thoracotomy was undertaken 2 to 4 weeks after completion of the chemoradiotherapy. Those with unresectable disease received boost radiotherapy. Results: From May 1999 to November 2002, 76 patients were enrolled, of whom 20 had T4 disease; 75 patients were fully assessable. Chemoradiotherapy was generally well tolerated. Fifty-seven patients (76%) underwent surgical resection, and pathologic complete resection was achieved in 51 patients (68%). There were 12 patients with pathologic complete response. Major postoperative morbidity, including chylothorax, empyema, pneumonitis, adult respiratory distress syndrome, and bleeding, was observed in eight patients. There were three treatment-related deaths, including two deaths owing to postsurgical complications and one death owing to sepsis during chemoradiotherapy. The disease-free and overall survival rates at 3 years were 49% and 61%, respectively; at 5 years, they were 45% and 56%, respectively. Conclusion: This trimodality approach is safe and effective for the treatment of patients with SSTs.

Original languageEnglish
Pages (from-to)644-649
Number of pages6
JournalJournal of Clinical Oncology
Volume26
Issue number4
DOIs
Publication statusPublished - 2008 Feb 1
Externally publishedYes

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Medical Oncology
Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Japan
Radiotherapy
Vindesine
Chylothorax
Neoplasms
Empyema
Adult Respiratory Distress Syndrome
Mitomycin
Thoracic Wall
Ribs
Thoracotomy
Cisplatin
Disease-Free Survival
Sepsis
Pneumonia
Survival Rate
Hemorrhage

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers : Report of Japan clinical oncology group trial 9806. / Kunitoh, Hideo; Kato, Harubumi; Tsuboi, Masahiro; Shibata, Taro; Asamura, Hisao; Ichonose, Yukito; Katakami, Nobuyuki; Nagai, Kanji; Mitsudomi, Tetsuya; Matsumura, Akihide; Nakagawa, Ken; Tada, Hirohito; Saijo, Nagahiro.

In: Journal of Clinical Oncology, Vol. 26, No. 4, 01.02.2008, p. 644-649.

Research output: Contribution to journalArticle

Kunitoh, Hideo ; Kato, Harubumi ; Tsuboi, Masahiro ; Shibata, Taro ; Asamura, Hisao ; Ichonose, Yukito ; Katakami, Nobuyuki ; Nagai, Kanji ; Mitsudomi, Tetsuya ; Matsumura, Akihide ; Nakagawa, Ken ; Tada, Hirohito ; Saijo, Nagahiro. / Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers : Report of Japan clinical oncology group trial 9806. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 4. pp. 644-649.
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abstract = "Purpose: To evaluate the safety and efficacy of preoperative chemoradiotherapy followed by surgical resection for superior sulcus tumors (SSTs). Patients and Methods: Patients with pathologically documented non-small-cell lung cancer with invasion of the first rib or more superior chest wall were enrolled as eligible; those with distant metastasis, pleural dissemination, and/or mediastinal node involvement were excluded. Patients received two cycles of chemotherapy every 4 weeks as follows; mitomycin 8 mg/m2 on day 1, vindesine 3 mg/m2 on days 1 and 8, and cisplatin 80 mg/m2 on day 1. Radiotherapy directed at the tumor and the ipsilateral supraclavicular nodes was started on day 2 of each course, at the total dose of 45 Gy in 25 fractions, with a 1-week split. Thoracotomy was undertaken 2 to 4 weeks after completion of the chemoradiotherapy. Those with unresectable disease received boost radiotherapy. Results: From May 1999 to November 2002, 76 patients were enrolled, of whom 20 had T4 disease; 75 patients were fully assessable. Chemoradiotherapy was generally well tolerated. Fifty-seven patients (76{\%}) underwent surgical resection, and pathologic complete resection was achieved in 51 patients (68{\%}). There were 12 patients with pathologic complete response. Major postoperative morbidity, including chylothorax, empyema, pneumonitis, adult respiratory distress syndrome, and bleeding, was observed in eight patients. There were three treatment-related deaths, including two deaths owing to postsurgical complications and one death owing to sepsis during chemoradiotherapy. The disease-free and overall survival rates at 3 years were 49{\%} and 61{\%}, respectively; at 5 years, they were 45{\%} and 56{\%}, respectively. Conclusion: This trimodality approach is safe and effective for the treatment of patients with SSTs.",
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T1 - Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers

T2 - Report of Japan clinical oncology group trial 9806

AU - Kunitoh, Hideo

AU - Kato, Harubumi

AU - Tsuboi, Masahiro

AU - Shibata, Taro

AU - Asamura, Hisao

AU - Ichonose, Yukito

AU - Katakami, Nobuyuki

AU - Nagai, Kanji

AU - Mitsudomi, Tetsuya

AU - Matsumura, Akihide

AU - Nakagawa, Ken

AU - Tada, Hirohito

AU - Saijo, Nagahiro

PY - 2008/2/1

Y1 - 2008/2/1

N2 - Purpose: To evaluate the safety and efficacy of preoperative chemoradiotherapy followed by surgical resection for superior sulcus tumors (SSTs). Patients and Methods: Patients with pathologically documented non-small-cell lung cancer with invasion of the first rib or more superior chest wall were enrolled as eligible; those with distant metastasis, pleural dissemination, and/or mediastinal node involvement were excluded. Patients received two cycles of chemotherapy every 4 weeks as follows; mitomycin 8 mg/m2 on day 1, vindesine 3 mg/m2 on days 1 and 8, and cisplatin 80 mg/m2 on day 1. Radiotherapy directed at the tumor and the ipsilateral supraclavicular nodes was started on day 2 of each course, at the total dose of 45 Gy in 25 fractions, with a 1-week split. Thoracotomy was undertaken 2 to 4 weeks after completion of the chemoradiotherapy. Those with unresectable disease received boost radiotherapy. Results: From May 1999 to November 2002, 76 patients were enrolled, of whom 20 had T4 disease; 75 patients were fully assessable. Chemoradiotherapy was generally well tolerated. Fifty-seven patients (76%) underwent surgical resection, and pathologic complete resection was achieved in 51 patients (68%). There were 12 patients with pathologic complete response. Major postoperative morbidity, including chylothorax, empyema, pneumonitis, adult respiratory distress syndrome, and bleeding, was observed in eight patients. There were three treatment-related deaths, including two deaths owing to postsurgical complications and one death owing to sepsis during chemoradiotherapy. The disease-free and overall survival rates at 3 years were 49% and 61%, respectively; at 5 years, they were 45% and 56%, respectively. Conclusion: This trimodality approach is safe and effective for the treatment of patients with SSTs.

AB - Purpose: To evaluate the safety and efficacy of preoperative chemoradiotherapy followed by surgical resection for superior sulcus tumors (SSTs). Patients and Methods: Patients with pathologically documented non-small-cell lung cancer with invasion of the first rib or more superior chest wall were enrolled as eligible; those with distant metastasis, pleural dissemination, and/or mediastinal node involvement were excluded. Patients received two cycles of chemotherapy every 4 weeks as follows; mitomycin 8 mg/m2 on day 1, vindesine 3 mg/m2 on days 1 and 8, and cisplatin 80 mg/m2 on day 1. Radiotherapy directed at the tumor and the ipsilateral supraclavicular nodes was started on day 2 of each course, at the total dose of 45 Gy in 25 fractions, with a 1-week split. Thoracotomy was undertaken 2 to 4 weeks after completion of the chemoradiotherapy. Those with unresectable disease received boost radiotherapy. Results: From May 1999 to November 2002, 76 patients were enrolled, of whom 20 had T4 disease; 75 patients were fully assessable. Chemoradiotherapy was generally well tolerated. Fifty-seven patients (76%) underwent surgical resection, and pathologic complete resection was achieved in 51 patients (68%). There were 12 patients with pathologic complete response. Major postoperative morbidity, including chylothorax, empyema, pneumonitis, adult respiratory distress syndrome, and bleeding, was observed in eight patients. There were three treatment-related deaths, including two deaths owing to postsurgical complications and one death owing to sepsis during chemoradiotherapy. The disease-free and overall survival rates at 3 years were 49% and 61%, respectively; at 5 years, they were 45% and 56%, respectively. Conclusion: This trimodality approach is safe and effective for the treatment of patients with SSTs.

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