Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial

@article{Albain2009RadiotherapyPC,
  title={Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial},
  author={K. Albain and R. Swann and V. Rusch and A. Turrisi and F. Shepherd and Colum Smith and Yuhchyau Chen and R. Livingston and R. Feins and D. Gandara and W. Fry and G. Darling and David H Johnson and Mark R. Green and RobertI Miller and Joanne Ley and Willliam T Sause and J. Cox},
  journal={The Lancet},
  year={2009},
  volume={374},
  pages={379-386}
}
BACKGROUND Results from phase II studies in patients with stage IIIA non-small-cell lung cancer with ipsilateral mediastinal nodal metastases (N2) have shown the feasibility of resection after concurrent chemotherapy and radiotherapy with promising rates of survival. We therefore did this phase III trial to compare concurrent chemotherapy and radiotherapy followed by resection with standard concurrent chemotherapy and definitive radiotherapy without resection. METHODS Patients with stage T1… Expand

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References

SHOWING 1-10 OF 29 REFERENCES
Randomized controlled trial of resection versus radiotherapy after induction chemotherapy in stage IIIA-N2 non-small-cell lung cancer.
TLDR
In selected patients with pathologically proven stage IIIA-N2 NSCLC and a response to induction chemotherapy, surgical resection did not improve overall or progression-free survival compared with radiotherapy, and radiotherapy should be considered the preferred locoregional treatment for these patients. Expand
A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer.
TLDR
In patients with Stage III non-small-cell lung cancer, induction chemotherapy with cisplatin and vinblastine before radiation significantly improves median survival and doubles the number of long-term survivors, as compared with radiation therapy alone. Expand
Preoperative chemotherapy followed by surgery compared with primary surgery in resectable stage I (except T1N0), II, and IIIa non-small-cell lung cancer.
TLDR
Although impressive differences in median, 3-year, and 4-year survival were observed, they were not statistically significant, except for stage I and II disease. Expand
Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA (N2) and IIIB non-small-cell lung cancer: mature results of Southwest Oncology Group phase II study 8805.
  • K. Albain, V. Rusch, +7 authors D. Gandara
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1995
TLDR
The strongest predictor of long-term survival after thoracotomy was absence of tumor in the mediastinal nodes at surgery, and this trimodality approach was feasible in this Southwest Oncology Group (SWOG) study. Expand
A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small-cell lung cancer.
TLDR
Preoperative chemotherapy increases the median survival in patients with non-small-cell lung cancer, and the prevalence of mutated K-ras oncogenes was 15 percent among the patients receiving preoperative chemotherapy and 42 percent among those treated with surgery alone. Expand
Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer.
TLDR
In selected patients with unresectable stage III NSCLC, the concurrent approach yields a significantly increased response rate and enhanced median survival duration when compared with the sequential approach. Expand
Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer: a Southwest Oncology Group phase II study, SWOG 9019.
TLDR
Feasibility and long-term survival support the application of these results as a standard against which mature outcomes of chemoRT trials with new chemotherapy agents can be compared, and justify use of the SWOG-9019 approach as a control arm in ongoing phase III trials. Expand
A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer.
TLDR
This clinical trial strengthens the validity of using perioperative chemotherapy in the management of patients with resectable stage IIIA non-small-cell lung cancer by suggesting that survival is improved when compared with treatment by surgery alone. Expand
Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients.
TLDR
The results observed in a large, randomized study that compared the effects of radiotherapy alone (the standard therapy) with those of a combination of radi therapy and chemotherapy in nonresectable squamous cell and large-cell lung carcinoma showed local control was poor in both groups and remained the major problem. Expand
Phase III study of concurrent chemotherapy and radiotherapy (CT/RT) vs CT/RT followed by surgical resection for stage IIIA(pN2) non-small cell lung cancer (NSCLC): Outcomes update of North American Intergroup 0139 (RTOG 9309)
TLDR
With longer follow-up, new analyses of primary endpoints PFS and OS were conducted and intent to treat analyses used Kaplan-Meier estimates, log-rank tests and Cox multivariate models; exploratory analyses used logistic regression. Expand
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