BACKGROUND: Stage IIIb (T4/N3) @entity1149 ( @entity1149 ) is considered an inoperable disease and treatment is an enduring challenge. Surgery after induction therapy seems to improve locoregional control. We report the results of a phase II prospective trimodality trial (chemotherapy and concomitant radiotherapy plus surgery) in @entity1 with stage IIIb @entity1149 . METHODS: From November 1992 to June 2000, 39 @entity1 (37 @entity1 and 2 @entity1 , mean age 65 years) with clinical stage IIIb (34 T4N0 to 2, 4 T2 to 3N3, 1 T4N3, excluding T4 for @entity3483 ) entered the study. They received intravenous infusions of @entity900 20 mg/m(2) and @entity1487 1,000 mg/m(2) (days 1 to 4 and 25 to 28) combined with a total dose of 50.4 Gy radiotherapy delivered over 4 weeks (1.8 Gy daily). Upon clinical restaging responders underwent surgery. RESULTS: All @entity1 were available for clinical restaging. No complete response was observed. Twenty-one @entity1 had partial response (53.8%), 16 had stable disease (41%), and 2 had progressive disease (5.2%). Hematologic @entity137 was moderate. Twenty-two @entity1 (56.4%), 21 with partial response and 1 with stable disease, underwent surgery with no perioperative @entity204 . A radical resection was possible in 21 cases. Nine lobectomies, 3 bilobectomies, and 9 pneumonectomies were performed. Complications occurred in 5 @entity1 (23.6%). Fourteen of the @entity1 who underwent surgery (66.6%) showed a pathologic downstaging. A complete pathologic response was obtained in 9 cases (49%). Overall 5-year survival (Kaplan-Meier) was 23%. Resected versus non-resected @entity1 showed a significant difference: 38% versus 5.6% (p = 0.028, log rank). CONCLUSIONS: This trimodal approach for stage IIIb @entity1149 appears safe and effective. It provides good therapeutic results with acceptable morbidity in surgical cases.

Enduring challenge in the treatment of XXXX with clinical stage IIIB: results of a trimodality approach.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'men'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small-cell lung cancer'] @entity3483 :: ('MESH:D016066', 'Disease') :: ['malignant pleural effusion'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity1149 :: (MESH:D002289,Disease) :: ['nonsmall cell lung cancer']
