Journal of Clinical Oncology, Vol 10, 580-586, Copyright © 1992 by American Society of Clinical Oncology
Induction chemotherapy with mitomycin, vindesine, and cisplatin for stage III unresectable non-small-cell lung cancer: results of the Toronto Phase II Trial
RL Burkes, RJ Ginsberg, FA Shepherd, ME Blackstein, ME Goldberg, PF Waters, GA Patterson, T Todd, FG Pearson and JD Cooper
Division of Medical Oncology, Mt Sinai Hospital, Toronto, Ontario, Canada.
PURPOSE: The 5-year survival rates with surgical resection for
preoperatively identified stage IIIA N2 non-small-cell lung cancer (NSCLC)
are less than 10%. A pilot study of mitomycin, vindesine, and cisplatin
(MVP) induction chemotherapy was undertaken in an attempt to improve the
curative potential of surgery in this group of patients. PATIENTS AND
METHODS: Thirty-nine patients with mediastinoscopy stage IIIA N2 NSCLC
received two cycles of MVP. Responding patients underwent thoracotomy for
resection and two further courses of MVP. RESULTS: The overall response
rate was 64% (25 of 39) with three complete and 22 partial responses.
Twenty-two patients were resected, which included a radical mediastinal
node dissection. Eighteen resections were complete and four were
incomplete. Pathologically, three patients (7.7%) had no tumor remaining.
Toxicity included two postoperative deaths secondary to a bronchopleural
(BP) fistula, mitomycin pulmonary toxicity in two patients, and septic
deaths in four patients. Twenty-eight patients have died; 20 have recurrent
or progressive disease. Eight of the 18 patients completely resected have
recurred, with a median time to recurrence of 20.6 months. Sites of
recurrence include two locoregional, five distant (two in brain), and one
in both. Median survival of all 39 patients is 18.6 months, with a 3-year
survival of 26%. The median survival for those patients completely resected
was 29.7 months with a 3-year survival of 40%. CONCLUSIONS: We conclude (1)
that MVP is an effective but toxic chemotherapeutic regimen for limited
NSCLC; (2) the median survival seems to be prolonged; and (3) the role of
induction chemotherapy followed by surgery in stage IIIA N2 NSCLC requires
a phase III randomized trial to compare it with other treatment modalities.
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Ann. Onc.,
November 1, 2004;
15(11):
1645 - 1653.
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|
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|
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|
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July 1, 2004;
15(7):
1048 - 1055.
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10(12):
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Ann. Thorac. Surg.,
April 1, 2003;
75(4):
1107 - 1112.
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|
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125(2):
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|
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74(2):
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|
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20(6):
1106 - 1112.
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|
|
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November 1, 2001;
120(5):
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|
|
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August 1, 2001;
20(2):
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|
|
|
|
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19(6):
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|
|
|
|
|
|
|
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August 1, 2000;
70(2):
391 - 395.
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|
|
|
|
|
|
|
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March 1, 2000;
119(3):
429 - 439.
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|
|
|
|
|
|
|
G. M. Strauss
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December 1, 1999;
116(suppl_3):
509S - 516S.
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|
|
|
|
|
|
|
K. Suzuki, K. Nagai, J. Yoshida, M. Nishimura, K. Takahashi, and Y. Nishiwaki
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J. Thorac. Cardiovasc. Surg.,
July 1, 1999;
118(1):
145 - 153.
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[Full Text]
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|
|
|
|
|
|
|
P. De Leyn, J. Vansteenkiste, G. Deneffe, D. Van Raemdonck, W. Coosemans, and T. Lerut
Result of induction chemotherapy followed by surgery in patients with stage IIIA N2 NSCLC: importance of pre-treatment mediastinoscopy
Eur. J. Cardiothorac. Surg.,
May 1, 1999;
15(5):
608 - 614.
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|
|
|
|
|
|
|
E. A. Rendina, F. Venuta, T. D. Giacomo, A. M. Ciccone, G. Ruvolo, G. F. Coloni, C. Ricci, and S. G. A. Patterson
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J. Thorac. Cardiovasc. Surg.,
February 1, 1999;
117(2):
225 - 233.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Vansteenkiste, P. De Leyn, G. Deneffe, J. Menten, T. Lerut, and M. Demedts
Present status of induction treatment in stage IIIA-N2 non-small cell lung cancer: a review
Eur. J. Cardiothorac. Surg.,
January 1, 1998;
13(1):
1 - 12.
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[Full Text]
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|
|
|
|
|
|
|
R. Nakanishi, T. Osaki, K. Nakanishi, I. Yoshino, T. Yoshimatsu, H. Watanabe, H. Nakata, and K. Yasumoto
Treatment Strategy for Patients With Surgically Discovered N2 Stage IIIA Non-Small Cell Lung Cancer
Ann. Thorac. Surg.,
August 1, 1997;
64(2):
342 - 348.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
D. J. Sugarbaker, J. Herndon, L. J. Kohman, M. J. Krasna, M. R. Green, t. C. a. L. G. B T. S. Group, and S. b. V. Rusch
Results of cancer and leukemia group B protocol 8935A multiinstitutional phase II trimodality trial for stage IIIa (N2) non-small-cell lung cancer
J. Thorac. Cardiovasc. Surg.,
March 1, 1995;
109(3):
473 - 485.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
R. Rosell, J. Gomez-Codina, C. Camps, J. Maestre, J. Padille, A. Canto, J. L. Mate, S. Li, J. Roig, A. Olazabal, et al.
A Randomized Trial Comparing Preoperative Chemotherapy Plus Surgery with Surgery Alone in Patients with Non-Small-Cell Lung Cancer
N. Engl. J. Med.,
January 20, 1994;
330(3):
153 - 158.
[Abstract]
[Full Text]
|
|
|
|
