Klin Onkol 2002; 15(1): 23-27.
Abstract:
Purpose: Our objective was to better define the activity, feasibility and toxicity of regional chemotherapy using an isolated thoracic perfusion (ITP) technique plus low dose systemic chemotherapy as induction chemotherapy in patients with Stage III non-small-cell lung cancer (NSCLC) followed by surgery within a pilot study.
Patients ond Methods:Twentytwo chemotherapynaive patients with NSCLC, median age of 57 years, Stage III IV disease with metastases only in thoracic region, Karnofsky – Index > 60, received two cycles of regional plus systemic chemotherapy with a treatment free interval of 4 weeks. Cytostatic regimen consisted of mitomycin 10 mg/m2, navelbine 25 mg/m2 and cisplatin 30 mg/m2 during ITP on day 1 plus low dose systemic chemotherapy with 5-floururacil 250 mg/m2and cisplatin 20 mg/m2 given as continuous infusion over 24 hours on day 1– 4. 4 weeks after second treatment re-evaluation for response and surgery was carried out, if possible.
Results:All 22 pts. were assessable for toxicity, response and survival. There were 19/22 remissions (CR 1; PR 12; MR 6) corresponding to a regression rate of 86,4 %. 16/22 pts. could be resected corresponding to a resectability rate of 72,7 % ( 13 complete resections R0, 1 R1, 2 R2 ) Side-effects were transient and acceptable with no treatment or surgery related death. Median survival has not been reached after an observation time of 15 months. 1-year survival rate was 67,3 %.
Conclusion:Regional chemotherapy using an ITP application form plus low-dose systemic chemotherapy is highly active in primary advanced NSCLC stage III IV leading to a high resectability rate with an encouraging survival outcome.
