Long-term observations of induction chemoradiotherapy against induction chemotherapy for the potentially resection stage IIIA (N2) non-small-cell lung cancer

Zakharychev V.D.,Gordiychuk P.I.,Borysyuk B.O.

Main
Publications
Long-term observations of induction chemoradiotherapy against induction chemotherapy for the potentially resection stage IIIA (N2) non-small-cell lung cancer

August 15, 2025

583

УДК: 616.24

DOI: 10.32471/umj.1680-3051.268132

Keywords :

long-term and irrecided survival,

multimodal treatment,

neoadjuvant chemoradiotherapy,

neoadjuvant chemotherapy,

non-small cell lung cancer IIIA (N2)

Specialities :

Oncology, Hematology

Resume

Modern treatment strategies in the later stages NSCLC are very individualized and the subject of constant debate. The optimal treatment strategy for the NSCLC IIIA-N2 remains contradictory, and no treatment is clearly recommended.

Aim: to determine the overall survival and survival without relapse in patients of NSCLC IIIA (N2) after different multimodal treatment regimes.

Material and research methods. The effect of neoadjuvant chemoradiation therapy (NHRT) was studied in 43 patients, neoadjuvanta HT (NHT) in 200 and NHT with subsequent surgery and radiation therapy (RT) in adjuvant mode of 63 patients. In all groups of NHT patients included 4 HT cycles according to cisplatin + docetaxel or carboplatin + packlitaxel. The RT was performed in classical fractionation with a single dose of 2 Gy, a total dose (SOD) up to 50 gr, with subsequent performance of radical surgery. The studies were performed in the department of lung tumors and mediastinum of the National Cancer Institute.

Results. In the period up to 6 months, survival without relapse was the highest in the NHT + RT group, for NHRT and NHT groups, survival rates without relapse do not differ. From the period 12 months before the end of the study, the best survival without relapse is registered in the NHRT group. Patients with a phenomenon of full and high degree of morphological response of the tumor had a much longer survival period without recurrence and overall survival than other patients in their group. The largest number of patients with a full morphological response (FMR) was found in the NHRT group. This approach to treatment has been found to reduce the number of pneumonctomy in favor of resections. The total five-year survival rate was 30,1±5,7% in the NHRT group, 12,3±3,5% in the NHT group and 6,3±2,2% in the NHT group+ adjuvant RT.

Conclusions. NHPT shows the benefits of long-term survival of patients with stage IIIA (N2) NSCLC over other methods of neoadjuvant and adjuvant treatment in the long run. Five-year survival without relapse is noted only in the NHPT group and was 21.5±6.4%.

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