5-Year Survival of Non-Small Cell Lung Cancer Patients after Adjuvant Chemoimmunoradiotherapy Oleg Kshivets, M.D., Ph.D. Department of Surgery, Siauliai Public Hospital, Lithuania The 53 rd Annual Cancer Symposium of Society of Surgical Oncology New Orleans, The USA, 2000
Abstract: <ul><li>FIVE-YEAR SURVIVAL AND LIFE SPAN OF NON-SMALL CELL LUNG CANCER PATIENTS AFTER </li></ul><ul><li>ADJUVANT CHEMOIMMUNORADIOTHERAPY </li></ul><ul><li>O.Kshivets* Siauliai Cancer Center, Siauliai, Lithuania </li></ul><ul><li> </li></ul><ul><li>Purpose : This study aimed to determine expediency of adjuvant chemoimmunoradiotherapy (AT) for radical operated non-small cell lung cancer (C) patients (LCP) with pathologic stage II-III (T1-4N0-2M0G1-3). </li></ul><ul><li>Methods : In randomised trial (1985-1998) 5-year survival (5YS) of 54 radical operated LCP after AT (age=54.4 1.0 years; males=49, females=5; C size=4.7 0.2 cm) was compared with 5YS of 264 LCP after radical procedures (S) (age=55.8 0.5 years; males=240, females=24; C size=4.5 0.1 cm) and with 5YS of 86 radical operated LCP after postoperative radiation (R) (45-50 Gy) (age=58.0 0.8 years; males=74, females=12; C size=4.7 0.2 cm). Variables selected for 5YS study were sex, age, TNMG, cell type, C size. 1 cycle of chemoimmunotherapy (CAVT: cyclophosphamid 500 mg/m 2 IV+doxorubicin 50 mg/m 2 IV+vincristin 1.4 mg/m 2 IV on day 1; thymalin/taktivin 20 mg IM daily for 5 days) was given on 10-14 day after S. R (45-50 Gy) was administered since 7 day after 1 cycle. After R 3-4 courses of CAVT were repeated every 21-28 day. Representativeness of samplings was reached by means of randomisation based on unrepeated random selection. Multiple correspondence analysis (A), cluster A, confirmatory factor A, structural equation modeling, Monte Carlo simulation were used to determine any significant overall differences between survival of LCP after AT, S, R. </li></ul><ul><li>Results : 5YS was superior in AT group (64.8%: 35 from 54 LCP with N0-2; life span: LS=1998.2 156.9 days) compared with R group (45.3%: 39 from 86 LCP with N0-2; LS=1296.4 109.5 days) (P<0.001). 5YS of S group was 63.6% (168 from 264 LCP with N0-2; LS=1738.3 63.4 days) (P>0.05 for AT and P<0.001 for R). For LCP with N1-2 5YS was significantly superior for AT group (63.6%: 21 from 33; LS=1934.0 189.9 days) compared with S group (28.1%: 25 from 89; LS=1056.9 91.1 days) (P<0.001) and with R group (35.6%: 21 from 59; LS=1051.7 119.6 days) (P<0.001). Rates of age, sex, T1-4, G1-3, cell type, C size for LCP after AT, S and R were not significantly different. Structural equation modeling and Monte Carlo simulation confirmed significant overall differences between 5YS (P<0.05) and LS (P<0.001) of LCP with N1-2 after AT with respect to S or R; however, 5YS of LCP for N0 with or without AT and R were not significantly different. </li></ul>
Samplings: <ul><li>Lung Cancer Patients Lived More than 5 Years after Complete Resections..…... 242 </li></ul><ul><li>Lung Cancer Patients Died Because Generalization During First 5 Years after Complete Resections.…….…………... 162 </li></ul><ul><li>In All…………………………………...404 </li></ul>
Life Span of Died Lung Cancer Patients with N0-2 (n=162)
Conclusions: <ul><li>Adjuvant chemoimmunoradiotherapy significantly improved 5-year survival and life span of non-small cell lung cancer patients with N1-2 metastases after complete resections compared with surgery alone and postoperative radiotherapy. </li></ul><ul><li>One must be careful in using adjuvant chemoimmunoradiotherapy for lung cancer patients without lymph node metastases. </li></ul>
Address: <ul><li>Oleg Kshivets, M.D., Ph.D. </li></ul><ul><li>Consultant Thoracic/Abdominal Surgeon </li></ul><ul><li>Department of Surgery </li></ul><ul><li>Siauliai Public Hospital </li></ul><ul><li>Tilzes:42-16, LT78206, Siauliai, Lithuania </li></ul><ul><li>tel (37041)416614 </li></ul><ul><li>e-mail: [email_address] </li></ul>
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