Original articleGeneral thoracicNeoadjuvant Chemoradiation for Clinically Advanced Non-Small Cell Lung Cancer: An Analysis of 233 Patients
Section snippets
Material and Methods
The medical records of all patients undergoing anatomic pulmonary resection for NSCLC after neoadjuvant chemoradiation therapy at a Rush University Medical Center from January 1989 through December 2008 were recorded. Institutional Review Board approval was obtained to perform this retrospective study, and individual patient consent was waived.
Patients, generally, with clinically advanced NSCLC or histologically positive mediastinal lymph nodes were carefully selected for therapy by a
Results
We identified 233 patients who had undergone neoadjuvant chemoradiation therapy, followed by anatomic pulmonary resection (Table 1). These 233 patients represented those patients that who were successfully treated in the intent-to-treat trimodality paradigm and were 86% of the 272 patients in the total intent-to-treat population. Ultimately, 34 patients (14%) of the intent-to-treat population were excluded: 16 refused the surgical intervention, the disease progressed in 10, and 8 patients died.
Comment
The use of chemotherapy and radiotherapy in a neoadjuvant paradigm before anatomic pulmonary resection at Rush University Medical Center was largely based on the initially successful experience [6] and the subsequent respectable outcomes associated with its use [1, 4, 7, 8, 9] by the multidisciplinary lung cancer team. The successful experiences of others [10, 11, 12] have served to further support its use. Despite these favorable outcomes, the challenge remains in identifying those patients
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2019, Lung CancerCitation Excerpt :Lastly, postoperative mortality was not increased with moderate increases in RT dose, but higher degrees of dose-escalation (i.e., >59 Gy) did display numerically higher postoperative mortality. When taking neoadjuvant dose into account, the overall rates of PNC and pCR herein are comparable to existing data [2–13]. Of note, the dose-escalated patients’ rates were similar to the 63% PNC in RTOG 0229, but numerically higher than the 8% pCR in that trial [9].
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2018, Clinical Lung CancerThe History of the Department of Cardiovascular and Thoracic Surgery at Rush
2016, Seminars in Thoracic and Cardiovascular SurgeryCitation Excerpt :This name was suggested by a resident, Dr Russell Vestor (thoracic, 1987-1990) (Fig. 9A). The program expanded with Drs Warren and Kittle and the summation results of 233 patients was reported in 2010 by Dr Anthony Kim.19 The Rush Saturday morning thoracic surgical case conference was a classic.