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Does adjuvant chemotherapy decrease distant metastasis formation in patients with non-small cell lung cancer?

M R Green
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Abstract

Disseminated micrometastatic disease limits the effectiveness of even the most aggressive locoregional treatment strategies in patients with early stage non-small cell lung cancer. One trial of the Lung Cancer Study Group (LCSG) demonstrated a significant decrease in the hazard rate for distant recurrence produced by adjuvant CAP chemotherapy after surgical resection and radiation therapy. French investigators found a significant decrease in distant metastases formation following sequential chemotherapy, radiation, and then additional chemotherapy compared to radiation alone in patients with stage III disease. However, other completed trials are either inconclusive, incompletely analyzed thus far or show no evidence of an effect of adjuvant chemotherapy on distant metastases. Additional data from recently completed or current trials will hopefully clarify the impact of adjuvant chemotherapy on distant micrometastases in patients with potentially curable non-small cell lung cancer (NSCLC).

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Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungChemotherapy, AdjuvantClinical Trials as TopicCombined Modality TherapyHumansLung NeoplasmsMulticenter Studies as TopicNeoplasm MetastasisNeoplasm StagingRandomized Controlled Trials as TopicRemission InductionTreatment OutcomeJournal ArticleReview

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BibTeXRIS

M R Green. 1994. Does adjuvant chemotherapy decrease distant metastasis formation in patients with non-small cell lung cancer?. https://doi.org/10.1016/0169-5002(94)91681-0

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Adjuvant methotrexate, vinblastine and cisplatin chemotherapy for invasive transitional cell carcinoma: Taiwan experience.

PURPOSE: The feasibility of adjuvant cisplatin, methotrexate and vinblastine chemotherapy was evaluated in Taiwanese patients with invasive transitional cell carcinoma at high risk for recurrence. MATERIALS AND METHODS: We assigned 56 patients with high risk transitional cell carcinoma (vascular or lymphatic invasion in the primary tumor, poorly differentiated stage P2, P3, P4 or N+ and M0) to receive adjuvant chemotherapy after radical urological surgery. The chemotherapy consisted of 40 mg./m.2 methotrexate and 4 mg./m.2 vinblastine on days 1 and 8, and 100 mg./m.2 cisplatin on day 2 given in 6 courses at 21-day intervals. RESULTS: Median followup was 44 months. An average of 4.63 cycles of chemotherapy was administered. The median actual survival was 44 months, and the 1 and 3-year survival probabilities were 92% and 50%, respectively. The median disease-free survival was 15.5 months, and the 1 and 3-year disease-free survival probabilities were 66% and 28%, respectively. Only 5 (9%) and 1 (2%) patients had grades 3 and 4 leukopenia, respectively, and none died of sepsis. CONCLUSIONS: The use of adjuvant cisplatin, methotrexate and vinblastine chemotherapy in patients with invasive transitional cell carcinoma at high risk for recurrence is feasible with tolerable toxicity but randomized controlled trials will be required to assess the benefit.

Antineoplastic Combined Chemotherapy Protocols↗