Abstract:

Background: A combination of platinum-based chemotherapy and definitive radiotherapy is the standard of care for Stage III (N2) NSCLC patients who have single or multiple lymph node metastasis. However, lung resection could be performed in patients with residual disease without lymph node metastasis. Methods: Between January 2010 and December 2013 eligible patients had pathologically proven, stage IIIA/N2 non-small-cell lung cancer and were prospectively recorded. Those in the chemoradiotherapy group received three cycles of neoadjuvant chemotherapy (AUCx2 carboplatin and docetaxel 85 mg/m[2 ] docetaxel) and concurrent radiotherapy with 61.2 Gy in 34 fractions over 3 weeks followed by surgical resection. Also, a group of patients who had definitive chemoradiotherapy without chemoradiotherapy was compared with the surgical group. All patients in two groups were proven to have no N2 disease after chemoradiotherapy. Results: A total of 29 patients were enrolled, of whom 6 received chemoradiotherapy followed by surgical resection and 21 had chemoradiotherapy only.No patient died postoperatively.Two patients had severe toxicity. Median overall survival was 26.66 ± 4.35 and months) in the chemoradiotherapy + surgery group and 21.75 ± 4.82 months (4.0–38.6) in the chemoradiotherapy group (p=0, 275). Conclusion: Pulmonary resection after definitive chemoradiotherapy is safe and surgical resection after chemoradiotherapy may provide better survival in histologically proven N2 stage IIIA non-small cell lung cancer.

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