Abstract
Background For stage III, NSCLC neoadjuvant protocols have been intensified up to full dose
protocols but up till now the effect of more intensive protocols in a trimodal setting
could not be compared directly because of different selection criteria or experience
of involved facilities in different studies or multicenter studies. We analyzed our
experience with two different neoadjuvant protocols, consistent selection criteria,
and surgical teams over 17-year time period.
Method Single-center retrospective study in 159 patients concerning survival, recurrence,
and downstaging effect.
Results Overall median survival was 32 months, with 26 months for protocol 1, and 35 months
for protocol 2, respectively. Hospital mortality was 5%. Log-rank test showed significant
difference between the protocols for UICC-downstaging-effect, ypT-stage, ypN-stage,
and ypUICC-stage, respectively, but only ypN-stage and ypUICC-stage were significant
risk factors for survival using Cox regression.
Conclusion The median survival benefit of 9 months is evident but (probably still) not significant.
The more aggressive protocol 2 shows a significant better downstaging effect concerning
N- and UICC-stage if R0-resection can be achieved. Insofar dose does matter!
Keywords
airway (includes related subject matter) - chemotherapy - lung cancer treatment (surgery
medical)
