Preoperative chemotherapy followed by resection may produce better survival outcomes than chemoradiation alone for patients with lung cancer, according to a study published in Medical Science Monitor.
Current practice standards for lung cancer include surgery followed by adjuvant chemotherapy, neoadjuvant therapy followed by surgical resection, or definitive chemoradiation; however, a consensus about which approach is the most efficacious has not yet been reached.
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Therefore, in a study led by Thomas Bilfinger, Stony Brook University (Stony Brook, NY), researchers conducted a retrospective analysis of 127 patients with non-small cell lung cancer who were treated between 2002 and 2014 and had survived at least 5 years from their initial diagnosis in order to see how outcomes differed between those treated with neoadjuvant chemotherapy followed by resection, or a regimen of chemoradiation alone. Statistical analyses were used to evaluate treatment effects and adjust for possible confounders.
Researchers found that more patients were treated with chemoradiation alone (94 patients [74%]) than with neoadjuvant therapy followed by surgery (33 patients [26%]). Patients who received surgery also tended to be significantly younger than those who received chemoradiation alone (mean age 60.1 vs 69.7 years, respectively).
Overall, both short- and long-term survival outcomes for patients included in the trial were significantly higher in those that received neoadjuvant chemotherapy followed by resection than patients who were treated with chemoradiation alone, with 1-year survival rates being 94% an 63%, respectively, and 5-year survival rates being 63% and 19%, respectively.
Researchers concluded that neoadjuvant chemotherapy followed by surgery produced better results for patients with lung cancer than chemoradiation alone. While this treatment approach is only suitable for the healthiest candidates, new therapeutic options could help to expand the number of patients eligible for the procedure and further improve outcomes.
“The debate thus is no longer if neoadjuvant chemotherapy works,” authors of the study wrote, “but rather why does it fail or why is it not used more often.”
