Neoadjuvant Therapy for Resectable Non–Small Cell Lung Cancer with Mediastinal Lymph Node Involvement

摘要: The optimal treatment for stage IIIA (N2) NSCLC remains controversial. Numerous studies with induction chemotherapy or chemoradiotherapy show that both approaches in the neoadjuvant setting are feasible. Outcomes following therapy have been associated mediastinal nodal response, residual involvement a negative predictor of survival. Appropriate selection patients to undergo resection is critical. Lobectomy may be safely performed while pneumonectomy carry high and possibly unacceptable rate perioperative mortality. Combined modality has increased overall survival III NSCLC. Future trials looking at different regimens without radiotherapy surgery help identify ideal this heterogeneous disease stage. SAKK-16/00 study an ongoing phase European trial randomizing receive three cycles docetaxel cisplatin followed by radiation then surgical resection, same regimen alone. Other include investigations novel chemotherapeutic combinations, such as pemetrexed, II setting. RTOG 0229 evaluating paclitaxel carboplatin concurrently therapy, consolidation combination docetaxel, carboplatin, also currently being investigated trial. future lie outcome investigating molecularly targeted agents, EGFR inhibitors, anti-angiogenic multitargeted agents. Optimal incorporation into multimodality approach required locally advanced N2 will require careful investigation. results from these eagerly awaited.