266403 Perioperative chemotherapy in stage III non-small cell lung cancer: An East-Asian population-based study

Tuesday, October 30, 2012

Zhong-Zhe Lin , Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
Wen-Yi Shau , Division of Health Technology Assessment, Center For Drug Evaluation, Taipei, Taiwan
Raymond Kuo, PhD , Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei City, Taiwan
Yu-Yun Shao , Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
Yen-Yun Yang, MS , Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei City, Taiwan
Chih-Hsin Yang, MD, PhD , Department of Oncology, National Taiwan University Hospital, Taipei City, Taiwan
Mei-Shu Lai, MD, PhD , Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, Taiwan
Introduction: Patients with stage III non-small-cell lung cancer (NSCLC) usually require a combined modality therapeutic approach. Induction chemotherapy prior to curative surgery is frequently used in routine practice for patients with resectable stage III NSCLC. However, the survival advantage of the induction chemotherapy remains to be validated.

Methods: This study recruited patients aged 18 years or older with stage III NSCLC registered in the Taiwan Cancer Registry Database between January 2004 and December 2007. Based on the presence or absence of induction/adjuvant chemotherapy, those eligible patients were divided into four groups. Cisplatin-containing regimens should be used in the induction and/or adjuvant chemotherapy. Kaplan-Meier survival curves, log-rank tests, and the Cox proportional hazards regression model were used to assess the influence of various risk factors on survival time.

Results: The study group included 177 stage III NSCLC patients receiving curative operation. Ninety-three (53%) patient received induction cisplatin-based chemotherapy The median follow-up time was 28.3 months. The percentage of all cause of death for patients receiving induction chemotherapy without or with adjuvant chemotherapy were 46.0% and 44.6%, respectively. The percentage of all cause of death for patients receiving surgery alone or followed by adjuvant chemotherapy were 70.0% and 55.9%, respectively. Multivariate analysis identified cisplatin-based induction chemotherapy as an independent prognostic factor for all causes of death (Hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.37-0.92, P = 0.0198) and lung cancer specific death (HR 0.53, 95% CI 0.33-0.86, P = 0.0096).

Conclusion: Cisplatin-based induction chemotherapy should be considered in the treatment plan for stage III NSCLC patients.

Learning Areas:
Administration, management, leadership
Clinical medicine applied in public health
Epidemiology

Learning Objectives:
Evaluate the effectiveness of perioperative chemotherapy on stage III non-small cell lung cancer patients.

Keywords: Drug Use, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal inspector of the supporting research project and also one the author who prepared the draft. The submission of this abstract and acting as the presenter is agreed by all other co-authors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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