Konference: 2006 31st Congress ESMO - účast ČR
Zhoubné nádory plic a průdušek
Téma: Lung cancer
Číslo abstraktu: 749P
Autoři: prof. MUDr. Vítězslav Kolek, DrSc.; MUDr. Ivona Grygárková; MUDr. Karel Cwiertka, Ph.D.; doc. MUDr. Marián Hajdúch, Ph.D.; prof., MUDr. Jiří Klein, Ph.D., PETCS; doc. MUDr. Čestmír Neoral, CSc.
A prospective study evaluates the combination of neoadjuvant and
adjuvant chemotherapy in marginally resectable NSCLC stage IIIA.
Two regimens (3 cycles) of neoadjuvant therapy were applied in 65
patients (pts), 11 women and 54 men, mean age 59 years. Paclitaxel
(200 mg/m2 D1) and carboplatin (AUC 6 D1) was applied in 34 pts,
vinorelbin (30 mg/m2 D1+8) with carboplatin (AUC 6 D1) in 31 pts.
Surgical resection was performed in cases with objective response,
radiotherapy in cases with progression. Tumor cells were harvested
during surgery and tested with MTT (methylthiasol tetrazolium blue
test), which indicates in-vitro chemoresistence. Selective adjuvant
chemotherapy was applied sequentionally (3 cycles of two
cytostatics). In-vitro effective drugs were chosen, when MTT
results were obtained. Effectiveness and tolerability of the
treatment schema and survival of pts were evaluated. Out of 191
neoadjuvant chemotherapy cycles, onyl 15 were postponed and 3
reduced. Toxicity gr.4 (neutropeniy mainly) did not exceed 5%.
Downstaging was achieved in 34 pts (52.5%), diminishing of tumor in
15 pts (23.1%), complete resection could be realized in 47 pts
(72.3%). Out of 139 adjuvant chemotherapy cycles 39 were postponed
and 2 reduced. Toxicity Gr. 4 (anorexhia, neutropenia) reached
6.5%. 42 pts finished all the postponed therapeutic scheme. Median
survival (ms) of opeated pts was 44.6 months, 3-years survival rate
was 64.2% and 5-years survival rate 42.8%. Median of survival of
inoperable pts was 14.2 months. There were no significant
differences in ms between both neoadjuvant regimens (44m vs 43m).
5-year survival rate was slightly higher in pts with chemosensitive
tumors according to MTT (53.8%) than in pts with resistant tumors
ot tumors without known in-vitro chemoresistance (38.8%). Presented
therapeutic approach is considered as feasible, highly effective
and well tolerated of NSCLC.
Datum přednesení příspěvku: 29. 6. 2006