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N. Joxadze

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      121P - Primary surgery followed by chemotherapy versus definitive concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (ID 542)

      12:30 - 13:00  |  Author(s): N. Joxadze

      • Abstract
      • Slides

      Approximately 30–35% of patients present with locally advanced NSCLC(LAD-NSCLC) The majority of them can be treated with a combination of chemo. and radiation; however, a subset of stage III pat. are considered surgical candidates may require a modification of this plan. The purpose of this study is to compare effectiveness of primary surgery and chemotherapy versus chemoradiation in patients with LAD-NSCLC. To evaluate the survival parameters and treatment complications.

      NSCLC pat. with clinical stage IIIA and selected IIIB from 2014 to 2016 were identified retrospectively in two Institutions. Medical records reviewed. All patients were grouped in 2 treatment arms. Surgical arm: surg.+adj.chemotherapy and ChRT arm: Definitive Chemoradiotherapy.

      The medical records of 75 patients (39 Surgical and 35 ChRT arm) were reviewed. More than 1/2 in both arms were with scc (51% and 61%). The type of surgery was 15 lobec- and 24 pneumonectomies with complete mediastinal l/node dissection. In CHRT arm G3-4 hematology toxicity occurred in 19pat. and 6 patients had acute non-hematology toxicity(G3). No acute G 4 radiation toxicity developed. In surg. arm only 1 severe bleeding developed and reoperation was performed. 2 patients had wound healing problems. 5 treatment related deaths occurred: 3 in the surgical arm (2 pulmonary embolus and 1 cardiac complication) and 2 patients in chemoradiation arm(2 PE). The 1-year survival rate was 69% vs 61% in surg. and ChRT arms respectively, which was not statistically significant (p = 0.4604). No difference in the 1-year survival was observed in Stage IIIA 68% vs 58% (p = 0.5627) and in Stage IIIB 72% vs 62% (p = 0.5540) between arms. No difference on median survival time (17.5 vs 16.8 m).

      Treatment effectiveness, complications and 1-year survival rate were equal between the surgical and ChRT arms. These results seem to indicate primary surgery as the treatment of choice for stage IIIA and selected patients with stage IIIB NSCLC, whenever a complete resection is thought to be technically feasible and the patient's conditions compatible with the extent of the planned surgery. Further results of 3- and 5-year survival rates are awaited.

      Clinical trial identification:
      GYO LAD-NSCLC 002

      Legal entity responsible for the study:
      Georgian Group of Young Oncology

      Has not received any funding

      All authors have declared no conflicts of interest.

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