Preoperative chemotherapy in non-small cell lung cancer (NSCLC) — A pilot study

Abstract

At the time of diagnosis, 30 % of patients with non-small cell lung cancer have a localized tumor. In these patients in tumor stage I or II, surgical resection is the treatment of choice and may result in definite cure. Locally advanced or disseminated non-small cell lung cancer in most cases is not curable at the present time. 70 % of patients are inoperable at the time of diagnosis. Patients in stage IIIA are considered operable in selected cases, stage IIIB in most cases is considered inoperable. Thus, in the majority of cases surgical treatment is not possible due to the local extend of tumor spread. Survival of patients in advanced stage without treatment is in the range of 4 to 6 months. Surgery of selected patients or radiation therapy in these cases results in a median survival of 10 to 18 months. Because 30 to 50 % of patients with non-small cell lung cancer respond to chemotherapy, however, we tested whether in patients with primarily inoperable, locally advanced tumor chemotherapy would induce sufficient tumor regression to allow for subsequent surgery with curative intent.