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Annals of Oncology 2006 17(Supplement 2):ii28-ii31; doi:10.1093/annonc/mdj916
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© 2006 European Society for Medical Oncology

symposium article

Locally advanced non-small cell lung cancer: role of induction chemotherapy in resectable N2 disease

M. R. Migliorino1, L. De Petris1, S. De Santis1, A. Cipri1, R. Belli1, S. Condò1, O. Ariganello1, M. Di Molfetta1, A. Saponiero1 and F. de Marinis1,2,*

1 5th Pneumo-Oncology Unit, Department of Lung Diseases, San Camillo-Forlanini Hospitals, Rome; 2 Fo.R.O. (Oncological Research Foundation), Rome, Italy

* Correspondence to: Filippo de Marinis, 5th Pneumo-Oncology Unit, Dept. of Lung Diseases, S. Camillo-Forlanini Hospitals – via Portuense 332 – 00149 Rome, Italy. Tel/Fax: +39 06 5555 2565; E-mail: demarinis.filippo{at}virgilio.it

Patients with resectable stage IIIA-N2 non-small cell lung cancer should receive induction chemotherapy before surgery. The aim is to early control systemic disease, eventually cure the mediastinal tumor spread and improve patients' survival. A recent metanalysis of randomized trials with second-generation platinum-based combinations has reinforced the evidence concerning the benefit of induction chemotherapy followed by surgery versus surgery alone in resectable disease. Moreover a large number of phase II trials have explored the activity and feasibility of platinum-based combinations with third-generation drugs in the same setting. Still opened questions to address with current clinical research are the eventual role of radiotherapy as induction treatment, the impact of definite chemoradiation versus induction treatment followed by surgical resection on local control and survival and finally the non-easy choice between neo-adjuvant and adjuvant chemotherapy.

Key words: neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy, NSCLC, stage IIIA, N2


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