Results of Trimodality Therapy in Patients With Stage IIIA (N2-Bulky) and Stage IIIB Non–Small-Cell Lung Cancer

2009 ◽  
Vol 10 (5) ◽  
pp. 353-359 ◽  
Author(s):  
Jian Li ◽  
Chun-Hua Dai ◽  
Li-Chao Yu ◽  
Ping Chen ◽  
Xiao-Qin Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iiib ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Trimodality Therapy

scholarly journals Treatment outcome of locally advanced stage IIIA/B lung cancer

Medicina ◽  
2009 ◽  
Vol 45 (6) ◽  
pp. 452 ◽  
Author(s):  
Saulius Cicėnas ◽  
Aurelija Žalienė ◽  
Vydmantas Atkočius
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Total Dose ◽  
Median Survival ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iiib ◽  
Small Cell Lung ◽  
Stage Iiia

Objective. To determine survival of patients with stage IIIA/B non–small cell lung cancer considering disease stage and treatment methods. Material and methods. A total of 304 patients with non–small cell lung cancer were treated at the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University, in 2000–2004. Stage IIIA (T3N1-2M0) cancer was diagnosed for 193 (63.5%) patients and stage IIIB (T4N0-1M0) cancer was diagnosed for 111 (36.5%) patients. There were 277 (91.1%) males and 27 (8.9%) females. According to morphology, there were 219 (72%) patients with squamous cell lung cancer, 80 (26.3%) with adenocarcinoma, and 5 (1.7%) patients with large cell carcinoma. Surgery was performed in 145 patients: 84 (57.9%) patients underwent lung resection (T3-4N0-1M0), 51 (35.2%) patients – thoracotomy, and 10 (6.7%) patients – other palliative thoracic procedures (mediastinotomy, pleurectomy, mediastinoscopy). Forty-eight (30.2%) patients were treated with radiation therapy with total doses of >40 Gy and 58 (36.5%) patients were treated with radiation therapy with total doses of <40 Gy. Fifty-four (33.9%) patients were treated with Gemzar and cisplatin and 19 (11.9%) patients were treated with etoposide and cisplatin.Results. Overall median and mean survival was 7.8 months (95% CI, 6.8 to 8.8) and 9.9 months (95% CI, 9.0 to 10.9), respectively. The median and mean survival of patients with stage IIIA cancer was 8.3 months and 10.4 months, respectively, and that of patients with stage IIIB cancer – 6.4 months and 9.0 months, respectively (P≤0.05). The median survival of the patients with stage IIIA cancer who received a combination of operation, chemotherapy, and radiation therapy with a total dose of >40 Gy was 14.4 months (mean, 14.7 months), and the median survival of those who received operation, chemotherapy, and radiation therapy with a total dose of ≤40 Gy was 9.7 months (mean, 14.1 months); the median survival of the patients who underwent surgery alone was 4.9 months (mean, 6.7 months) (P=0.004 and P=0.007), respectively. There was a significant difference in the median survival comparing the patients with stage IIIB cancer who underwent surgery alone and those who received a combination of radiation therapy and chemotherapy (median survival of 5.0 months [mean, 8.1 months] versus 16.8 months [mean, 17.6 months], respectively; P≤0.05). Conclusions. Disease stage had an influence on the survival of patients with non–small cell lung cancer: patients with stage IIIA (T3N0-1M0) cancer without metastases to mediastinal lymph nodes (N factor) survived longer than patients with stage IIIB (T4N1-2M0) cancer, where not only N factor had an impact but T factor as well. Better treatment outcomes, i.e. longer survival, can be achieved when a combination of three treatment types – surgery, chemotherapy, and radiation therapy – is applied to patients with stage IIIA or IIIB non–small cell lung cancer. The patients with stage IIIA disease who received surgery and radiation therapy (total dose, >40 Gy), and combinations of surgery, chemotherapy, and radiation therapy and second-line chemotherapy showed a significantly longer survival than those who received surgery alone.

Trimodality therapy in the treatment of stage IIIA non-small cell lung cancer (NSCLC): Analysis of the National Cancer Database.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 7514-7514 ◽  
Author(s):  
Madhusmita Behera ◽  
Conor Ernst Steuer ◽  
Felix Fernandez ◽  
Yuan Liu ◽  
Chao Fu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
National Cancer Database ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Trimodality Therapy

scholarly journals Surgical resection of stage IIIA and stage IIIB non-small-cell lung cancer after concurrent induction chemoradiotherapy

1993 ◽  
Vol 105 (1) ◽  
pp. 97-106 ◽  
Author(s):  
Valerie W. Rusch ◽  
Kathy S. Albain ◽  
John J. Crowley ◽  
Thomas W. Rice ◽  
Vassyl Lonchyna ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Surgical Resection ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iiib ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Induction Chemoradiotherapy

scholarly journals STAGE III A & B NON-SMALL CELL LUNG CANCER

2007 ◽  
Vol 14 (01) ◽  
pp. 181-186
Author(s):  
SHAHAR YAR ◽  
IJAZ HUSSAIN SHAH ◽  
ABRAR AHMED JAVED ◽  
Abid Jamil ◽  
Abubaker Shahid ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iiib ◽  
Disease Stage ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Hilar Lymph Node

Stage IIIA Non- Small Cell Lung Cancer (NSCLC) is characterized by the presence of ipsilateral mediastinal and / or sub carinal nodal involvement (N2) associated with a T1 or T2 primary lesion or a T3 lesion associated either with positive hilar nodes (N1) or with N2 nodal disease. Stage IIIB disease is characterized by scalene, supra-clavicular, contra lateral mediastinal, or contralateral hilar lymph node involvement (N3) associated with any T category or a T4 primary tumor associated with any N category1. Patients with stage IIIA disease can be stratified into those with bulky and nonbulky disease, based upon the presence of lymph nodes >2 cm in short-axis diameter, or groupings of multiple smaller lymph nodes 2. Patients with bulky stage IIIA or those with stage IIIB disease are generally considered inoperable.

Cause of death among patients with non-small cell lung cancer treated with postoperative radiation therapy (PORT).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20555-e20555
Author(s):  
Aashray Singareddy ◽  
Saiama Naheed Waqar ◽  
Siddhartha Devarakonda ◽  
Jeffrey P. Ward ◽  
Ramaswamy Govindan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cause Of Death ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iiib ◽  
Small Cell Lung ◽  
Stage Iiia

e20555 Background: The indications for post-operative radiation therapy (PORT) in locally advanced non-small cell lung cancer (NSCLC) remain undefined and a major concern is the perceived risk of increased mortality from cardiopulmonary causes. The purpose of this study was to quantify the rate of cardiopulmonary death in patients with resected NSCLC receiving PORT using a large national database. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database for lung cancer, patients with Stage IIIA or Stage IIIB NSCLC according to the 6th AJCC edition treated with surgery followed by PORT, who also received chemotherapy were identified. Cause of death was categorized as due to lung cancer, other cancer, cardiac, pulmonary, or other and reported as a percentage of total deaths at one and 2 years. Kaplan-Meier survival analysis was done to compare overall survival between Stage IIIA and IIIB patients. Results: From 2004 to 2015, 4387 patients with stage IIIA and IIIB meeting the eligibility criteria were identified. The median age at diagnosis was 65 years old, most patients were male (53%), Caucasian (83%), had adenocarcinoma (54.8%), stage IIIA disease (69%), and N2 disease (78%). The median overall survival for Stage IIIA and IIIB patients was 39 months and 27 months respectively (p < 0.001). Among the 2586 patients that died during the study period, the most common COD was lung cancer (81.3%). Cardiac and pulmonary COD occurred in 86 patients (3.3% of deaths) and 84 patients (3.2% of deaths) respectively, whereas 158 patients (6.1%) died from other cancers and 154 (5.9%) from other causes. There were 77 deaths from cardiopulmonary cause at 2 years (1.7% of patients and 2.9% of deaths). Cardiopulmonary COD was more common in patients with stage IIIB compared to IIIA disease (4.9% vs 3.3% of deaths, p < 0.001). Lung cancer was the most common COD both at 1 and 2 years (85%) whereas cardiopulmonary was the COD in 5.2% of patients at 1 year and 5.1% at 2 years. Conclusions: This analysis showed a low cardiopulmonary mortality from PORT in the first 2 years. The role for adjuvant radiotherapy remains undefined and treatment decisions for patients with resected stage III NSCLC should be guided by co-morbidities and the competing risk for death from lung cancer.

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