open access

Vol 3, No 5 (2007)
Review paper
Published online: 2007-10-17
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New approach to postoperative adjuvant treatment in non-small-cell lung cancer

Maciej Krzakowski
Onkol. Prak. Klin 2007;3(5):233-240.

open access

Vol 3, No 5 (2007)
REVIEW ARTICLES
Published online: 2007-10-17

Abstract

Depending on the pathological stage at presentation, 40-75% of non-small-cell lung cancer patients die within 5 years despite complete resection alone. The majority of them experience distant relapse. Postoperative radiotherapy may decrease the rate of local relapse in patients with pN2 disease, but has a detrimental effect on survival in stage pI and pII patients. The value of postoperative adjuvant chemotherapy has been a matter of discussion for many years. Three randomised trials published in recent years together with two large meta-analyses provided evidence in favour of adjuvant chemotherapy with an absolute benefit of 4-15% in 5 years. Survival benefit was found mainly in stage pII and pIIIA patients. At present, postoperative chemotherapy may be regarded as standard approach in these patients provided they represent good performance status. The major issue now is to identify subsets of patients who could tolerate chemotherapy better and have greater benefit from adjuvant chemotherapy. Both aims could be achieved in future by genetic and molecular-based selection.

Abstract

Depending on the pathological stage at presentation, 40-75% of non-small-cell lung cancer patients die within 5 years despite complete resection alone. The majority of them experience distant relapse. Postoperative radiotherapy may decrease the rate of local relapse in patients with pN2 disease, but has a detrimental effect on survival in stage pI and pII patients. The value of postoperative adjuvant chemotherapy has been a matter of discussion for many years. Three randomised trials published in recent years together with two large meta-analyses provided evidence in favour of adjuvant chemotherapy with an absolute benefit of 4-15% in 5 years. Survival benefit was found mainly in stage pII and pIIIA patients. At present, postoperative chemotherapy may be regarded as standard approach in these patients provided they represent good performance status. The major issue now is to identify subsets of patients who could tolerate chemotherapy better and have greater benefit from adjuvant chemotherapy. Both aims could be achieved in future by genetic and molecular-based selection.
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Keywords

non-small-cell lung cancer; adjuvant treatment; postoperative chemotherapy

About this article
Title

New approach to postoperative adjuvant treatment in non-small-cell lung cancer

Journal

Oncology in Clinical Practice

Issue

Vol 3, No 5 (2007)

Article type

Review paper

Pages

233-240

Published online

2007-10-17

Bibliographic record

Onkol. Prak. Klin 2007;3(5):233-240.

Keywords

non-small-cell lung cancer
adjuvant treatment
postoperative chemotherapy

Authors

Maciej Krzakowski

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