JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Domenico Galetta
Alfredo Cesario
Stefano Margaritora
Pierluigi Granone
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Galetta, D.
Right arrow Articles by Russo, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Galetta, D.
Right arrow Articles by Russo, P.
Related Collections
Right arrow Lung - cancer
Right arrow Lung - other

J Thorac Cardiovasc Surg 2006;131:314-321
© 2006 The American Association for Thoracic Surgery

General Thoracic Surgery

Multimodality treatment of unresectable stage III non–small cell lung cancer: Interim analysis of a phase II trial with preoperative gemcitabine and concurrent radiotherapy

Domenico Galetta, MD a , Alfredo Cesario, MD b , g , * , Stefano Margaritora, MD b , Venanzio Porziella, MD b , Alessio Piraino, MD b , Rolando M. D'Angelillo, MD c , Maria A. Gambacorta, MD c , Sara Ramella, MD c , Lucio Trodella, MD c , Salvatore Valente d , Giuseppe M. Corbo d , Giuseppe Macis e , Antonino Mulè f , Vittorio Cardaci, MD h , Silvia Sterzi, MD i , Pierluigi Granone, MD b , Patrizia Russo, PhD b

a Department of Thoracic Surgery, European Institute of Oncology, Milan
b Division of General Thoracic Surgery, Catholic University, Rome
c Department of Radiotherapy, Catholic University, Rome
d Division of Respiratory Physiology, Catholic University, Rome
e Department of Radiology, Catholic University, Rome
f Department of Pathology, Catholic University, Rome
g Clinical, Respiratory Pathology Translational Laboratory, San Raffaele, IRCCS, Rome
h Department of Pulmonary Rehabilitation, San Raffaele, IRCCS, Rome
i Rehabilitation Service, University Campus Bio-Medico, Rome, Italy.

Read at the Thirtieth Annual Meeting of the Western Thoracic Surgical Association, Maui, Hawaii, June 23-26, 2004.

Received for publication June 19, 2005; revisions received July 2, 2005; accepted for publication July 11, 2005.

* Address for reprints: Alfredo Cesario, MD, Division of General Thoracic Surgery, Catholic University, Largo A. Gemelli, 8, 00168 Rome, Italy. (Email: alfcesario{at}rm.unicatt.it).

OBJECTIVE: We report the preliminary results of a phase II trial undertaken to determine the feasibility and efficacy of gemcitabine and concurrent radiotherapy in patients with inoperable stage III non–small cell lung cancer.

METHODS: Between February 2001 and June 2003, a total of 46 patients (37 male and 9 female, median age 64 years) with clinical stage III non–small cell lung cancer (41 cIIIA and 5 cIIIB) were enrolled in a combined chemoradiation protocol with gemcitabine as the chemotherapeutic agent. Gemcitabine (350 mg/m2) was administered weekly for 5 consecutive weeks as a 30-minute intravenous infusion before radiotherapy (total dose 50.4 Gy, 1.8 Gy/d). Toxicity was routinely assessed. Those patients with disease judged to be resectable at restaging underwent surgery.

RESULTS: Toxicity was moderate, with the exception of 1 grade 3 thrombocytopenia. All but 5 patients were available for restaging. No complete responses were observed. Thirty-four patients (82.9%) had partial responses, 5 (12.2%) had stable disease, and 2 (4.9%) had progressive disease. Twenty-nine of 46 patients (63%, 27 cIIIA and 2 cIIIB) underwent surgery. Radical resection was possible in all cases. Surgery included 17 lobectomies, 4 bilobectomies, and 8 pneumonectomies. There were no deaths. Morbidity was 13.8% (4/29). Pathologic downstaging to stage 0 or I was observed in 18 patients (39%, 18/46). After a median follow-up of 13 months (range 2-28 months), 24 of the patients who had undergone operation (86.2%) were alive, with a median disease-free survival of 16 months. Overall 2-year survival was 66.1%, with a significant difference between resected and unresected disease (82% vs 36%, P = .0002).

CONCLUSION: The results of this induction trial confirm the feasibility and the efficacy of gemcitabine with concurrent radiotherapy.

Abbreviations and Acronyms CT = computed tomography; NSCLC = non–small cell lung cancer; PD = progressive disease; PR = partial response; SD = stable disease




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
N. Pourel, N. Santelmo, N. Naafa, A. Serre, W. Hilgers, L. Mineur, N. Molinari, and F. Reboul
Concurrent cisplatin/etoposide plus 3D-conformal radiotherapy followed by surgery for stage IIB (superior sulcus T3N0)/III non-small cell lung cancer yields a high rate of pathological complete response
Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 829 - 836.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 by The American Association for Thoracic Surgery.