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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2000 December;41(6):935-9

lingua: Inglese

A randomized trial of postoperative CDDP-based chemotherapy-chemoradiotherapy vs short-term immunochemotherapy in lung cancer

Sagawa M., Sato M., Fujimura S., Usuda K. *, Kondo T., Tanita T., Takahashi S. *, Ono S., Matsumura Y., Handa M. *, Saito Y. **

From the Department of Thoracic Surgery Institute of Development, Aging and Cancer Tohoku University,
*Department of Surgery Sendai Kosei Hospital
**Department of Thoracic Surgery National Sendai Hospital**, Sendai, Japan


Background. Although a few ­reports indi­cat­ed ­some ben­e­fit to sur­vi­val, the ­effect of adju­vant ther­a­py for the ­patients ­with resect­ed ­lung can­cer was ­still con­tro­ver­sial. The aim of our ­study was to eval­u­ate sur­vi­val advan­tage of ­CDDP-­based adju­vant ther­a­py com­pared ­with ­short-­term immu­noch­e­mo­ther­a­py.
Methods. Experimental ­design: pros­pec­tive ran­dom­ized ­trial. Patients: ­from 1990 ­through 1994, 94 ­patients ­were reg­is­tered. Forty-sev­en ­patients ­were ran­dom­ly ­assigned to ­each ­group, i.e., ­CDDP-­based ther­a­py ­group (CB Group, ­CDDP+VDS+teg­a­fur+OK-432 or ­CDDP+OK-432+med­i­as­ti­nal irra­di­a­tion) or immu­noch­e­mo­ther­a­py ­group (IC Group, teg­a­fur+OK-432). Patients in ­both ­groups ­were fol­lowed at 4-­month inter­vals ­with the rou­tine fol­low-up pro­gram of our depart­ment.
Results. No sig­nif­i­cant dif­fer­ence was ­observed ­between the ­patients’ char­ac­ter­is­tics of two ­groups. Compliance of the reg­i­men in ­each ­group was 79% in CB Group and 85% in IC Group. No treat­ment-relat­ed ­death was ­observed. Five-­year sur­vi­val ­rates of CB Group and IC Group ­were 49% and 51%, and 5-­year dis­ease-­free sur­vi­val ­rates ­were 46% and 44%, respec­tive­ly. There ­were no sta­tis­ti­cal dif­fer­enc­es ­between the two ­groups. Furthermore, no sur­vi­val dif­fer­enc­es ­could be ­found ­between CB Group and IC Group in any sub­group of ­patients.
Conclusions. Both of ­these reg­i­mens ­were fea­sible. However, we ­have not ­observed any sur­vi­val ben­e­fit in the CB Group in any sub­group, so far. Induction ther­a­py, new chem­o­ther­a­peu­tic ­agents, or ­anti-angiog­e­net­ic ­agents may ­improve the sur­vi­val of sur­gi­cal­ly treat­ed ­lung can­cer ­patients.

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