Journal of Clinical Oncology, Vol 10, 1927-1932, Copyright © 1992 by American Society of Clinical Oncology
Adjuvant chemotherapy after radical surgery for non-small-cell lung cancer: a randomized study
A Niiranen, S Niitamo-Korhonen, M Kouri, A Assendelft, K Mattson and S Pyrhonen
Department of Radiotherapy and Oncology, Helsinki University Central Hospital, Finland.
PURPOSE: The aims of this study were to assess the effect of adjuvant
chemotherapy on overall survival, disease-free survival, and relapse
pattern, as well as its toxicity in patients who underwent radical surgery
for non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: One hundred
ten patients with T1-3N0 (World Health Organization [WHO] 1981) NSCLC
underwent radical surgery during the period of 1982 through 1987. After
surgery, the patients were randomized to receive adjuvant chemotherapy (n =
54) (cyclophosphamide 400 mg/m2, doxorubicin 40 mg/m2, and cisplatin 40
mg/m2 [CAP] for six cycles) or no active treatment (n = 56). RESULTS: After
10 years from the start of the study, 61% of patients were alive in the
chemotherapy group and 48% were alive in the control group (P = .050).
Seventeen patients (31%) in the CAP group and 27 patients (48%) in the
control group had a recurrence during the follow-up period (P = .01). The
5-year survival rate was 67% in the chemotherapy group and was 56% in the
control group (P = .050). The patients in the chemotherapy group who
completed the planned treatment had a slightly better 5-year survival than
those whose chemotherapy was discontinued (72.5% v 50.3%; P = .15).
Chemotherapy-related gastrointestinal toxicity grade 3 to 4 (WHO) occurred
in 63% and was the main reason why patients refused further planned
therapy. CONCLUSION: Our results suggest that patients with NSCLC at
pathologic stage I who have undergone radical surgery benefit from adjuvant
chemotherapy.
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