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Neoadjuvant chemotherapy of stage III‐A and B lung carcinoma using the pacco regimen
Author(s) -
Takita Hiroshi,
Blumenson Leslie E.,
Raghavan Derek
Publication year - 1995
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930590303
Subject(s) - medicine , chemotherapy , vincristine , regimen , cyclophosphamide , stage (stratigraphy) , oncology , neoadjuvant therapy , surgery , doxorubicin , carcinoma , cancer , paleontology , breast cancer , biology
Previously, we reported an effective chemotherapeutic combination regimen for non‐small cell lung carcinoma (NSCLC): cisplatinum, doxorubicin, cyclophosphamide, CCNU, and vincristine (PACCO). Forty‐one patients with a diagnosis of NSCLC Stages III‐A and III‐B were entered into the protocol of neoadjuvant PACCO chemotherapy. Following two courses of chemotherapy, the patients were evaluated for surgical therapy. The overall response rate to the chemotherapy was 60%. Subsequently, 65% of the patients underwent surgical resection. The overall estimated median survival was 18 months. The survival of patients in III‐A was 36 months and that of III‐B was 18 months (95% confidence lower bounds for III‐A: 8 months and for III‐B: 13 months). There was one chemotherapy‐related mortality but no surgical mortality. Neoadjuvant chemotherapy with PACCO regiment offers an alternative to chemoradiation therapy, without increasing the surgical mortality, and should be validated in a randomized clinical trial. For successful neoadjuvant chemotherapy of Stage III NSCLC, chemotherapy combination which would give a high response rate without significant side effects must be chosen.