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V. Pajares



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    P2.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 966)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.17-17 - Multimodal Treatment in Pathologically Confirmed Single-Station Resectable IIIA-N2 Non-Small Cell Lung Cancer: A Single Center Experience (ID 13747)

      16:45 - 18:00  |  Author(s): V. Pajares

      • Abstract

      Background

      The management of patients with resectable stage IIIA-N2 (7th Edition) non-small cell lung cancer (NSCLC) is controversial. Multimodal treatment with neoadjuvant chemotherapy (CT) and radiotherapy (RT) followed by surgery may be recommended for a selected group of patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We have retrospectively analyzed 21 patients with single-station resectable stage IIIA-N2 NSCLC treated in our center from April 2011 to June 2017. N2 was confirmed by EBUS or mediastinoscopy. Patients received CT with cisplatin (70 mg/m2)/carboplatin (5AUC) + vinorelbine (25 mg/m2 C1, 15 mg/m2 C2-3) concurrent RT with the 2nd cycle of CT with a total dose of 60Gy. PET-CT and mediastinoscopy was performed after induction treatment, and only those patients with mediastinal downstaging disease were proposed for surgery (lobectomy + systematic lymph node dissection). Kaplan-meier analysis was used to evaluate local control (LC), Overall survival (OS), Cause-specific-survival (CSS) and Disease-free-survival (DFS).

      4c3880bb027f159e801041b1021e88e8 Result

      13 patients were males (62%) and 8 females (38%), median age was 63 (52-75). Histology was: 10(48%) adenocarcinoma, 6(28%) squamous and 5 (24%) NOS NSCLC. Surgery was not performed in 5 patients (24%): 1 presented progressive disease, 2 had persistent mediastinum disease and 2 were excluded due to comorbidities. No severe postoperative complications were observed in patients who underwent surgery. Table 1 shows the results.

      With a median follow up of 49 (10-84) months, significant differences in terms of OS (p=0,002) and in CSS (p=0,006) were observed between patients with/without surgery, with no difference in LC and DFS. In patients who underwent surgery, there was a trend to a better LC, OS, CSS, DFS when complete pathological response was achieved.

      table 1.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      In patients with pathologically confirmed single-station resectable stage IIIA-N2 NSCLC multimodal treatment with high dose

      radiotherapy is feasible and with a trend to better outcome in patients with complete pathological response.

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