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1. Rusch VW, Giroux DJ, Kraut MJ, Crowley J, Hazuka M, Johnson D, Goldberg M, Detterbeck F, Shepherd F, Burkes R, Winton T, Deschamps C, Livingston R, Gandara D: Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160). J Thorac Cardiovasc Surg; 2001 Mar;121(3):472-83
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  • [Title] Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160).
  • OBJECTIVE: The rate of complete resection (50%) and the 5-year survival (30%) for non-small cell lung carcinomas of the superior sulcus have not changed for 40 years.
  • Recently, combined modality therapy has improved outcome in other subsets of locally advanced non-small cell lung carcinoma.
  • This trial tested the feasibility of induction chemoradiation and surgical resection in non-small cell lung carcinoma of the superior sulcus with the ultimate aim of improving resectability and survival.
  • METHODS: Patients with mediastinoscopy-negative T3-4 N0-1 superior sulcus non-small cell lung carcinoma received 2 cycles of cisplatin and etoposide chemotherapy concurrent with 45 Gy of radiation.
  • All patients received 2 more cycles of chemotherapy and were followed up by serial radiographs and scans.
  • Induction therapy was completed as planned in 102 (92%) patients.
  • There were 3 treatment-related deaths (2.7%).
  • CONCLUSIONS:. (1) This combined modality treatment is feasible in a multi-institutional setting;.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Feasibility Studies. Female. Humans. Male. Prognosis

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  • (PMID = 11241082.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] United States
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2. Rusch VW, Parekh KR, Leon L, Venkatraman E, Bains MS, Downey RJ, Boland P, Bilsky M, Ginsberg RJ: Factors determining outcome after surgical resection of T3 and T4 lung cancers of the superior sulcus. J Thorac Cardiovasc Surg; 2000 Jun;119(6):1147-53
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  • [Title] Factors determining outcome after surgical resection of T3 and T4 lung cancers of the superior sulcus.
  • BACKGROUND: The treatment of superior sulcus lung cancers is evolving and preoperative chemotherapy is increasingly used.
  • To establish a historical benchmark against which new therapies can be assessed, we reviewed our 24-year experience with patients undergoing thoracotomy for lung cancers of the superior sulcus.
  • The majority of patients (55%) received preoperative radiation, but 35% did not have any preoperative treatment.
  • CONCLUSIONS: Our results provide a benchmark against which new treatment regimens can be evaluated.
  • Control of locoregional disease remains the major challenge in treating lung cancers of the superior sulcus.
  • The potential benefit of preoperative chemotherapy or chemoradiotherapy must be assessed by whether it leads to higher rates of complete resection and a lower risk of local relapse.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / mortality. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / mortality. Lung Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 10838531.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 25
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3. Pisters KM, Vallières E, Crowley JJ, Franklin WA, Bunn PA Jr, Ginsberg RJ, Putnam JB Jr, Chansky K, Gandara D: Surgery with or without preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer: Southwest Oncology Group Trial S9900, an intergroup, randomized, phase III trial. J Clin Oncol; 2010 Apr 10;28(11):1843-9
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  • [Title] Surgery with or without preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer: Southwest Oncology Group Trial S9900, an intergroup, randomized, phase III trial.
  • PURPOSE Patients with early-stage non-small-cell lung cancer (NSCLC) have a poor prognosis even after complete resection.
  • Earlier studies of preoperative (induction) chemotherapy in resectable NSCLC demonstrated feasibility and encouraging survival data.
  • PATIENTS AND METHODS Patients with clinical stage IB-IIIA NSCLC (excluding superior sulcus tumors and N2 disease) were eligible.
  • The primary end point was OS; secondary end points were progression-free survival (PFS), chemotherapy response, and toxicity.
  • RESULTS The trial closed early with 354 patients after reports of a survival benefit for postoperative chemotherapy in other studies.
  • The median OS was 41 months in the surgery-only arm and 62 months in the preoperative chemotherapy arm (hazard ratio, 0.79; 95% CI, 0.60 to 1.06; P = .11.
  • ) The median PFS was 20 months for surgery alone and 33 months for preoperative chemotherapy (hazard ratio, 0.80; 95% CI, 0.61 to 1.04; P = .10.
  • ) Major response to chemotherapy was seen in 41% of patients; no unexpected toxicity was observed.
  • CONCLUSION This trial closed prematurely after compelling evidence supporting postoperative chemotherapy emerged.
  • Although OS and PFS were higher with preoperative chemotherapy, the differences did not reach statistical significance.
  • At present, stronger evidence exists for postoperative chemotherapy in early-stage NSCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / drug therapy. Lung Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / secondary. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Carcinoma, Large Cell / drug therapy. Carcinoma, Large Cell / secondary. Carcinoma, Large Cell / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Survival Rate. Thoracic Surgery. Treatment Outcome

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  • (PMID = 20231678.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / N01 CA004919; United States / NCI NIH HHS / CA / CA86780; United States / NCI NIH HHS / CA / CA37981; United States / NCI NIH HHS / CA / CA58348; United States / NCI NIH HHS / CA / CA58416; United States / NCI NIH HHS / CA / CA46136; United States / NCI NIH HHS / CA / CA35261; United States / NCI NIH HHS / CA / U10 CA004919; United States / NCI NIH HHS / CA / N01 CA035431; United States / NCI NIH HHS / CA / CA22433; United States / NCI NIH HHS / CA / CA12644; United States / NCI NIH HHS / CA / CA20319; United States / NCI NIH HHS / CA / N01 CA032102; United States / NCI NIH HHS / CA / U10 CA035192; United States / NCI NIH HHS / CA / CA58658; United States / NCI NIH HHS / CA / U10 CA014028; United States / NCI NIH HHS / CA / N01 CA035119; United States / NCI NIH HHS / CA / N01 CA046441; United States / NCI NIH HHS / CA / CA14028; United States / NCI NIH HHS / CA / CA45377; United States / NCI NIH HHS / CA / U10 CA074647; United States / NCI NIH HHS / CA / CA58861; United States / NCI NIH HHS / CA / CA35090; United States / NCI NIH HHS / CA / N01 CA063844; United States / NCI NIH HHS / CA / CA46282; United States / NCI NIH HHS / CA / U10 CA035261; United States / NCI NIH HHS / CA / U10 CA035178; United States / NCI NIH HHS / CA / CA76447; United States / NCI NIH HHS / CA / U10 CA105409; United States / NCI NIH HHS / CA / U10 CA032102; United States / NCI NIH HHS / CA / U10 CA046282; United States / NCI NIH HHS / CA / CA105409; United States / NCI NIH HHS / CA / CA67663; United States / NCI NIH HHS / CA / N01 CA035178; United States / NCI NIH HHS / CA / N01 CA038926; United States / NCI NIH HHS / CA / U10 CA067575; United States / NCI NIH HHS / CA / U10 CA046441; United States / NCI NIH HHS / CA / U10 CA045377; United States / NCI NIH HHS / CA / CA35192; United States / NCI NIH HHS / CA / CA74647; United States / NCI NIH HHS / CA / U10 CA020319; United States / NCI NIH HHS / CA / CA46113; United States / NCI NIH HHS / CA / U10 CA038926; United States / NCI NIH HHS / CA / U10 CA086780; United States / NCI NIH HHS / CA / U10 CA042777; United States / NCI NIH HHS / CA / U10 CA035431; United States / NCI NIH HHS / CA / U10 CA035119; United States / NCI NIH HHS / CA / CA42777; United States / NCI NIH HHS / CA / N01 CA067575; United States / NCI NIH HHS / CA / U10 CA067663; United States / NCI NIH HHS / CA / CA76429; United States / NCI NIH HHS / CA / U10 CA035090; United States / NCI NIH HHS / CA / U10 CA063844; United States / NCI NIH HHS / CA / U10 CA058861
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2860367
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4. Wright CD, Menard MT, Wain JC, Donahue DM, Grillo HC, Lynch TJ, Choi NC, Mathisen DJ: Induction chemoradiation compared with induction radiation for lung cancer involving the superior sulcus. Ann Thorac Surg; 2002 May;73(5):1541-4
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  • [Title] Induction chemoradiation compared with induction radiation for lung cancer involving the superior sulcus.
  • BACKGROUND: The usual approach of induction radiation therapy (RT) followed by resection of superior sulcus tumors results in many incomplete resections, a high local recurrence rate, and suboptimal survival.
  • Induction chemoradiotherapy (CT/RT) has been shown to reduce local and distant recurrences and improve survival in stage III lung cancer.
  • We investigated the role of induction CT/RT in superior sulcus patients.
  • RESULTS: From 1985 to 2000, 35 consecutive patients underwent induction treatment followed by resection of a superior sulcus tumor.
  • Twenty patients had induction RT (mean, 39 Gy), and 15 had induction CT/RT (mean, 51 Gy) with concurrent cisplatin-based chemotherapy.
  • There was no treatment mortality.
  • The pathologic response from the induction treatment was complete or near complete in 7 of 20 (35%) of the RT patients and in 13 of 15 (87%) of the CT/RT patients (p = 0.001).
  • CONCLUSIONS: Induction CT/RT for superior sulcus tumors appears to offer improved survival compared with induction RT alone.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / radiotherapy. Cisplatin / administration & dosage. Lung Neoplasms / radiotherapy. Neoadjuvant Therapy. Pneumonectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Radiotherapy Dosage. Survival Rate

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  • (PMID = 12022546.001).
  • [ISSN] 0003-4975
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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7. Sagerup CM, Brustugun OT, Jørgensen L: [A 67-year old man with right arm paresthesias]. Tidsskr Nor Laegeforen; 2009 Dec 17;129(24):2613-5
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  • An X-ray of the thorax showed a mass in the superior sulcus on the right side.
  • Biopsy revealed a non-small cell carcinoma of the lung.
  • The patient underwent a tri-modal treatment regimen with induction chemotherapy (two courses of cisplatin and etopside) and concomitant radiotherapy (50 Gy in 2 Gy fractions) before a right upper lobectomy was performed.
  • Pancoast tumours are an infrequent subtype of lung cancers.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / diagnosis. Lung Neoplasms / diagnosis. Pancoast Syndrome / diagnosis. Paresthesia / diagnosis
  • [MeSH-minor] Aged. Arm / physiopathology. Combined Modality Therapy. Diagnosis, Differential. Humans. Male. Positron-Emission Tomography. Prognosis. Tomography, X-Ray Computed

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  • [CommentIn] Tidsskr Nor Laegeforen. 2009 Dec 17;129(24):2615-6 [20029559.001]
  • (PMID = 20029558.001).
  • [ISSN] 0807-7096
  • [Journal-full-title] Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
  • [ISO-abbreviation] Tidsskr. Nor. Laegeforen.
  • [Language] nor
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Norway
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8. Pfannschmidt J, Muley T, Hoffmann H, Dienemann H: [Surgery in non-small cell lung cancer of the superior sulcus: results of a combined preoperative and postoperative irradiation regime]. Zentralbl Chir; 2004 Aug;129(4):270-5
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  • [Title] [Surgery in non-small cell lung cancer of the superior sulcus: results of a combined preoperative and postoperative irradiation regime].
  • [Transliterated title] Ergebnisse der Chirurgie im Konzept mit kombinierter prä- und postoperativer Strahlentherapie bei nicht-kleinzelligem Bronchialkarzinom des Sulcus superior.
  • Due to local invasion of the chest wall, patients with non small cell carcinoma (NSCLC) of the superior sulcus have been treated mainly by the Paulson regime with radiotherapy followed by surgical resection.
  • Recent published data on the use of concurrent irradiation and chemotherapy followed by surgical resection seemed very promising.
  • PATIENTS AND METHODS: Between 1986 and 2003, 64 patients with non-small cell carcinoma of the superior sulcus were managed in our department.
  • 28 underwent surgical resection with combined preoperative 40 Gy and postoperative 20 Gy external beam radiotherapy.
  • Time to death was calculated using the method of Kaplan and Meier.
  • CONCLUSIONS: Results of this retrospective study show that patients with non-small cell carcinoma of the superior sulcus can experience a long-term survival which is well comparative to other patients with NSCLC.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Carcinoma, Non-Small-Cell Lung / radiotherapy. Carcinoma, Non-Small-Cell Lung / surgery. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Lung Neoplasms / radiotherapy. Lung Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Biopsy, Needle. Bronchoscopy. Combined Modality Therapy. Disease Progression. Female. Follow-Up Studies. Humans. Lung / pathology. Lymphatic Metastasis. Male. Middle Aged. Multicenter Studies as Topic. Pneumonectomy. Postoperative Care. Preoperative Care. Prognosis. Radiotherapy Dosage. Retrospective Studies. Survival Analysis. Time Factors

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  • (PMID = 15354247.001).
  • [ISSN] 0044-409X
  • [Journal-full-title] Zentralblatt für Chirurgie
  • [ISO-abbreviation] Zentralbl Chir
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] Germany
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9. Tsuchida M, Hashimoto T, Shinohara H, Hosaka Y, Satoh S, Shirato T, Kitahara A, Hayashi J: [Induction chemoradiation followed by resection through anterior approach for superior sulcus tumor]. Kyobu Geka; 2010 Jan;63(1):29-33
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  • [Title] [Induction chemoradiation followed by resection through anterior approach for superior sulcus tumor].
  • A transcutaneous needle biopsy confirmed non-small-cell lung cancer.
  • Under the diagnosis of superior sulcus tumor in stage IIIB (T4N0M0), induction chemotherapy and radiation were given.
  • For the treatment of anterior superior sulcus tumors, anterior approach provides a safe and effective exposure.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy. Pancoast Syndrome / therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Humans. Male. Middle Aged

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  • (PMID = 20077829.001).
  • [ISSN] 0021-5252
  • [Journal-full-title] Kyobu geka. The Japanese journal of thoracic surgery
  • [ISO-abbreviation] Kyobu Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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10. Shimizu K, Nakata M, Maeda A, Yukawa T, Hirami Y, Tanemoto K, Oka M: Induction chemoradiation therapy with cisplatin plus irinotecan followed by surgical resection for superior sulcus tumor. Ann Thorac Cardiovasc Surg; 2010 Oct;16(5):326-30
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  • [Title] Induction chemoradiation therapy with cisplatin plus irinotecan followed by surgical resection for superior sulcus tumor.
  • PURPOSE: In this study, we retrospectively evaluate the safety and efficacy of induction chemoradiation using cisplatin plus irinotecan followed by surgical resection for superior sulcus tumor (SST).
  • METHODS: We reviewed the records of four patients with solitary, previously untreated T3-4, N0-1 superior sulcus nonsmall cell lung cancers.
  • Patients received two cycles of chemotherapy, cisplatin and irinotecan, every 4 weeks.
  • Radiotherapy directed at the tumor was administered with a split schedule at the total dose of 40 Gy in 20 fractions.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Camptothecin / analogs & derivatives. Carcinoma, Non-Small-Cell Lung / therapy. Cisplatin / administration & dosage. Lung Neoplasms / therapy
  • [MeSH-minor] Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Pneumonectomy. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome

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  • (PMID = 21030918.001).
  • [ISSN] 2186-1005
  • [Journal-full-title] Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
  • [ISO-abbreviation] Ann Thorac Cardiovasc Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 7673326042 / irinotecan; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
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11. Rusch VW, Giroux DJ, Kraut MJ, Crowley J, Hazuka M, Winton T, Johnson DH, Shulman L, Shepherd F, Deschamps C, Livingston RB, Gandara D: Induction chemoradiation and surgical resection for superior sulcus non-small-cell lung carcinomas: long-term results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160). J Clin Oncol; 2007 Jan 20;25(3):313-8
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  • [Title] Induction chemoradiation and surgical resection for superior sulcus non-small-cell lung carcinomas: long-term results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160).
  • PURPOSE: Traditional treatment for superior sulcus non-small-cell lung cancers (SS NSCLC), radiation plus surgery, yields a 50% rate of complete resection and a 30% 5-year survival.
  • PATIENTS AND METHODS: Patients with T3-4, N0-1 SS NSCLC received two cycles of cisplatin and etoposide concurrently with radiation (45 Gy).
  • All patients received two more cycles of chemotherapy.
  • Induction therapy was completed by 104 (95%) patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Neoadjuvant Therapy. Remission Induction

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  • [CommentIn] J Clin Oncol. 2007 May 20;25(15):2146; author reply 2147 [17513829.001]
  • (PMID = 17235046.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA12644; United States / NCI NIH HHS / CA / CA14028; United States / NCI NIH HHS / CA / CA20319; United States / NCI NIH HHS / CA / CA21115; United States / NCI NIH HHS / CA / CA22433; United States / NCI NIH HHS / CA / CA23318; United States / NCI NIH HHS / CA / CA25224; United States / NCI NIH HHS / CA / CA32102; United States / NCI NIH HHS / CA / CA32291; United States / NCI NIH HHS / CA / CA35176; United States / NCI NIH HHS / CA / CA37981; United States / NCI NIH HHS / CA / CA38926; United States / NCI NIH HHS / CA / CA46113; United States / NCI NIH HHS / CA / CA46282; United States / NCI NIH HHS / CA / CA46368; United States / NCI NIH HHS / CA / CA46441; United States / NCI NIH HHS / CA / CA49957; United States / NCI NIH HHS / CA / CA52772; United States / NCI NIH HHS / CA / CA58882; United States / NCI NIH HHS / CA / CA66636
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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12. Favaretto A, Pasello G, Loreggian L, Breda C, Braccioni F, Marulli G, Stragliotto S, Magro C, Sotti G, Rea F: Preoperative concomitant chemo-radiotherapy in superior sulcus tumour: A mono-institutional experience. Lung Cancer; 2010 May;68(2):228-33
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  • [Title] Preoperative concomitant chemo-radiotherapy in superior sulcus tumour: A mono-institutional experience.
  • Superior sulcus tumour (SST) is an uncommon neoplasia whose optimal treatment remains controversial.
  • Usually resected after induction RT or treated with definitive chemo-radiotherapy, it has recently aroused more interest because of preoperative chemo-radiotherapy.
  • Treatment consisted of a platinum-based chemotherapy: carboplatin AUC 5 on days 1 and 22, combined with mitomycin-C 8 mg/m(2) on days 1 and 22, and vinblastine 4 mg/m(2) on days 1, 8, 22 and 29 (MVC) from 1994 to 1999, or combined with navelbine 25mg/m(2) on days 1, 8, 22 and 29 (NC), from 2000 to 2007.
  • Radiotherapy was administered 5 days/week, 30 Gy in 10 fractions on days 22-35 (from 1994 to 1996), or 44 Gy in 22 fractions on days 22-52 (from 1997 to 2007).
  • Induction chemotherapy: 16 pts had MVC (43%) and 21 NC (57%); induction radiotherapy: 7 patients treated with MVC had 30 Gy/10F, 9 had 44 Gy/22F; all the patients treated with NC had 44 Gy/22F, but 2 of them did not complete radiotherapy because of early death (after 16 Gy/8F) and toxicity (after 38 Gy/19F).
  • In the multimodality treatment of SST, concurrent carboplatin-based chemotherapy plus radiotherapy were active and feasible without major toxicities.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Pneumonectomy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Carboplatin / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Male. Middle Aged. Mitomycin / therapeutic use. Preoperative Care. Radiotherapy, Adjuvant. Vinblastine / therapeutic use

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  • [Copyright] Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 19632000.001).
  • [ISSN] 1872-8332
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; 5V9KLZ54CY / Vinblastine; BG3F62OND5 / Carboplatin
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13. Girard N, Mornex F: [Therapeutic strategies in superior sulcus tumors: a model for combined modality therapy in non-small cell lung cancer]. Cancer Radiother; 2007 Jan-Feb;11(1-2):59-66
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  • [Title] [Therapeutic strategies in superior sulcus tumors: a model for combined modality therapy in non-small cell lung cancer].
  • [Transliterated title] Traitement des tumeurs de l'apex: un modèle de stratégie multimodale dans les cancers bronchiques localement évolués.
  • Superior sulcus tumors have been individualized among other non-small cell lung cancers because of their characteristic clinical presentation in connection with their local extension to the chest wall and the brachial plexus.
  • For a long time considered as marginally resectable, superior sulcus tumors have been treated since the early 1960's, with a combined approach including preoperative radiotherapy and curative-intent surgery.
  • Two recent phase II trials showed the benefit, both regarding resectability and local control rates, and survival of combined therapeutic strategies including induction platinum-based chemoradiation, extensive surgical resection, and adjuvant chemotherapy.
  • Adjuvant radiotherapy is not recommended at the time, but needs to be re-evaluated regarding its recent technical optimisation.
  • Similarly to other locally advanced non-small cell lung cancers, exclusive chemoradiation is the standard treatment of unresectable superior sulcus tumors.
  • In this way, radiotherapy has shown to offer a prolonged analgesia in more than 75% of cases, and is associated with concurrent or sequential chemotherapy, with comparable results to those observed in stage III lung cancer.
  • These developments make superior sulcus tumors a therapeutic model for locally advanced non-small cell lung cancer, whereby the benefit of combined multimodal strategies including induction chemoradiation and surgical resection are currently evaluated in phase III trials.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy. Neoadjuvant Therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging. Pneumonectomy. Prognosis. Radiotherapy, Adjuvant. Survival Rate

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  • (PMID = 17197220.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 60
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14. Bruzzi JF, Komaki R, Walsh GL, Truong MT, Gladish GW, Munden RF, Erasmus JJ: Imaging of non-small cell lung cancer of the superior sulcus: part 1: anatomy, clinical manifestations, and management. Radiographics; 2008 Mar-Apr;28(2):551-60; quiz 620
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  • [Title] Imaging of non-small cell lung cancer of the superior sulcus: part 1: anatomy, clinical manifestations, and management.
  • Non-small cell carcinomas of the superior pulmonary sulcus represent 3% of all lung cancers and are associated in most cases with a poor clinical outcome.
  • Multimodality therapy with irradiation, chemotherapy, and surgery offers the best possibility for long-term survival and cure in most cases.
  • For patients with pulmonary sulcus tumors that are not surgically resectable, chemoradiotherapy may help prolong survival and provide long-term pain relief.
  • To accurately determine tumor resectability and to help optimize the planning and delivery of therapy, radiologists need a detailed knowledge of the clinical and imaging manifestations of disease in the individual patient and an awareness of the therapeutic options available.
  • Familiarity with the complex anatomy of the superior pulmonary sulcus is particularly crucial for determining the local-regional extension of a tumor and the most appropriate surgical approach.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / diagnosis. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / diagnosis. Lung Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Contrast Media. Fluorodeoxyglucose F18. Humans. Imaging, Three-Dimensional. Magnetic Resonance Imaging. Radiography, Thoracic. Radiopharmaceuticals. Tomography, Emission-Computed. Tomography, X-Ray Computed

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  • [Copyright] (c) RSNA, 2008
  • (PMID = 18349457.001).
  • [ISSN] 1527-1323
  • [Journal-full-title] Radiographics : a review publication of the Radiological Society of North America, Inc
  • [ISO-abbreviation] Radiographics
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Contrast Media; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Number-of-references] 29
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15. Kunitoh H, Kato H, Tsuboi M, Shibata T, Asamura H, Ichinose Y, Katakami N, Nagai K, Mitsudomi T, Matsumura A, Nakagawa K, Tada H, Saijo N, Japan Clinical Oncology Group: Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers: report of Japan Clinical Oncology Group trial 9806. J Clin Oncol; 2008 Feb 1;26(4):644-9
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  • [Title] Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers: report of Japan Clinical Oncology Group trial 9806.
  • PURPOSE: To evaluate the safety and efficacy of preoperative chemoradiotherapy followed by surgical resection for superior sulcus tumors (SSTs).
  • PATIENTS AND METHODS: Patients with pathologically documented non-small-cell lung cancer with invasion of the first rib or more superior chest wall were enrolled as eligible; those with distant metastasis, pleural dissemination, and/or mediastinal node involvement were excluded.
  • Patients received two cycles of chemotherapy every 4 weeks as follows; mitomycin 8 mg/m(2) on day 1, vindesine 3 mg/m(2) on days 1 and 8, and cisplatin 80 mg/m(2) on day 1.
  • Radiotherapy directed at the tumor and the ipsilateral supraclavicular nodes was started on day 2 of each course, at the total dose of 45 Gy in 25 fractions, with a 1-week split.
  • There were three treatment-related deaths, including two deaths owing to postsurgical complications and one death owing to sepsis during chemoradiotherapy.
  • CONCLUSION: This trimodality approach is safe and effective for the treatment of patients with SSTs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery. Premedication
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Disease-Free Survival. Female. Humans. Male. Middle Aged. Mitomycins / therapeutic use. Neoplasm Recurrence, Local. Neoplasm Staging. Radiation Dosage. Radiography, Thoracic. Radiotherapy, Adjuvant. Survival Rate. Thoracotomy. Vinblastine / therapeutic use

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  • [ErratumIn] J Clin Oncol. 2011 Nov 20;29(33):4472. Ichonose, Yukito [corrected to Ichinose, Yukito]
  • (PMID = 18235125.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Mitomycins; 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; MVP protocol 2
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16. Komaki R, Roth JA, Walsh GL, Putnam JB, Vaporciyan A, Lee JS, Fossella FV, Chasen M, Delclos ME, Cox JD: Outcome predictors for 143 patients with superior sulcus tumors treated by multidisciplinary approach at the University of Texas M. D. Anderson Cancer Center. Int J Radiat Oncol Biol Phys; 2000 Sep 1;48(2):347-54
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  • [Title] Outcome predictors for 143 patients with superior sulcus tumors treated by multidisciplinary approach at the University of Texas M. D. Anderson Cancer Center.
  • PURPOSE: Superior sulcus tumors (SST) of the lung are uncommon and constitute approximately 3% of non-small cell lung cancer (NSCLC).
  • Prognostic factors and most effective treatments are controversial.
  • In this study, we examine the 5-year survival rate by pretreatment tumor and patient characteristics and by the treatments received.
  • 03), or vertebral body (p = 0.05) involvement, stage of the disease (p < 0.01), and surgical treatment (p < 0.01).
  • For patients with Stage IIB disease, surgical treatment (p < 0.01) and weight loss (p = 0.01) were significant independent predictors of 5-year survival.
  • For patients with Stage IIIB disease, the only independent predictor of survival was a right superior sulcus location, which was associated with a worse 5-year survival rate than that for patients with tumors in the left superior sulcus (p = 0.02).
  • Patients without gross residual disease after surgical resection who received postoperative radiation therapy with total doses of 55 to 64 Gy had a 5-year survival rate of 82% as compared with the 5-year survival rate of 56% in patients who received 50 to 54 Gy.
  • Of these, 4 patients (17%) received radiation therapy alone or in combination with chemotherapy without surgical resection.
  • The other 19 patients (83%) had resection combined with radiation therapy and/or chemotherapy.
  • Disease that is minimally invading surrounding normal structures can be resected followed by radiation therapy in doses of 55 to 64 Gy.
  • Further investigation of treatment strategies combining high-dose radiation therapy (>/=66 Gy) with chemotherapy is indicated for patients with unresectable and/or node-positive (N2) SST.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / mortality. Lung Neoplasms / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Brain Neoplasms / secondary. Combined Modality Therapy. Female. Humans. Karnofsky Performance Status. Male. Middle Aged. Neoplasm Staging. Radiotherapy Dosage. Retrospective Studies. Spinal Neoplasms / secondary. Survival Rate. Survivors. Texas. Treatment Outcome. Weight Loss

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  • (PMID = 10974447.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P01CA06294; United States / NCI NIH HHS / CA / P30CA16672; United States / NCI NIH HHS / CA / T32CA77050
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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17. Pourel N, Santelmo N, Naafa N, Serre A, Hilgers W, Mineur L, Molinari N, Reboul F: Concurrent cisplatin/etoposide plus 3D-conformal radiotherapy followed by surgery for stage IIB (superior sulcus T3N0)/III non-small cell lung cancer yields a high rate of pathological complete response. Eur J Cardiothorac Surg; 2008 May;33(5):829-36
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  • [Title] Concurrent cisplatin/etoposide plus 3D-conformal radiotherapy followed by surgery for stage IIB (superior sulcus T3N0)/III non-small cell lung cancer yields a high rate of pathological complete response.
  • INTRODUCTION: Optimal preoperative treatment of stage IIB (Pancoast)/III non-small cell lung cancer (NSCLC) remains undetermined and a subject of controversy.
  • The goal of our study is to confirm feasibility and pathological response rates after induction chemoradiation (CRT) in our community-based treatment center.
  • Induction treatment comprised 3D conformal 4500 cGy radiotherapy delivered to the primary tumor and pathologic hilar and/or mediastinal lymph nodes on CT scan with an extra-margin of 1-1.5 cm.
  • Concurrent chemotherapy regimen was cisplatinum 20mg/m2 d1-d5 and etoposide 50mg/m2 d1-d5, d1-5 d29-33.
  • Inoperable pts were referred for a 20-25 Gy boost +/-1 extra-cycle of cisplatinum+etoposide.
  • RESULTS: From 1996 to 2005, 107 pts were initially selected for treatment and received induction chemoradiation (stage IIB-Pancoast 18, IIIA 58 and IIIB 31, squamous cell carcinoma 48%, adenocarcinoma 44%, large-cell undifferentiated carcinoma 14%).
  • During the 3-month postoperative time, five patients (6.9%) died, four after pneumonectomy (right 3, left 1).
  • Median follow-up time was 22.3 months (survivors: 36.8 months), 2-year and 3-year overall survival rates were 55% and 40%, respectively (median=26.7 months) for all the intention-to-treat population (n=107), 62% and 51% (median=36.5 months) for 71 resected pts, 41% and 16% for 36 non-resected pts (median=19.1 months).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Cisplatin / therapeutic use. Etoposide / therapeutic use. Lung Neoplasms / drug therapy. Radiotherapy, Conformal / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Feasibility Studies. Female. Follow-Up Studies. Humans. Male. Middle Aged. Pneumonectomy. Proportional Hazards Models. Radiotherapy Dosage. Survival Rate. Treatment Outcome

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  • (PMID = 18367406.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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18. Pisters KM, Ginsberg RJ, Giroux DJ, Putnam JB Jr, Kris MG, Johnson DH, Roberts JR, Mault J, Crowley JJ, Bunn PA Jr: Induction chemotherapy before surgery for early-stage lung cancer: A novel approach. Bimodality Lung Oncology Team. J Thorac Cardiovasc Surg; 2000 Mar;119(3):429-39
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  • [Title] Induction chemotherapy before surgery for early-stage lung cancer: A novel approach. Bimodality Lung Oncology Team.
  • OBJECTIVE: This phase II trial assessed the feasibility, as measured by response rate, toxicity, resectability rate, and surgical morbidity and mortality rates, of perioperative paclitaxel and carboplatin chemotherapy in patients with early-stage non-small cell lung carcinoma.
  • METHODS: All patients required negative mediastinoscopy results and adequate medical parameters to undergo induction chemotherapy and an operation.
  • Superior sulcus patients were excluded.
  • Chemotherapy consisted of paclitaxel 225 mg/m(2) over 3 hours and carboplatin (area under the curve = 6) every 21 days for 2 cycles preoperatively.
  • Three postoperative cycles of chemotherapy were planned for patients undergoing complete resection.
  • After induction chemotherapy, 53 of 94 (56%; 95% confidence interval, 46%-67%) had a major objective response, 88 (94%) underwent surgical exploration, and 81 (86%; 95% confidence interval, 78%-92%) underwent complete resection.
  • Ninety (96%) patients received the planned preoperative chemotherapy versus 45% receiving postoperative chemotherapy.
  • No unexpected chemotherapy or surgical morbidity occurred.
  • CONCLUSIONS: Induction chemotherapy with paclitaxel and carboplatin is feasible and produces a high response rate with acceptable morbidity and mortality rates in early-stage non-small cell lung carcinoma.
  • A prospective randomized trial comparing 3 cycles of induction chemotherapy and surgery with surgery alone in early-stage non-small cell lung carcinoma is planned.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carboplatin / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy. Paclitaxel / therapeutic use
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Feasibility Studies. Female. Humans. Male. Middle Aged. Neoplasm Staging. Postoperative Care. Preoperative Care. Prospective Studies

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  • (PMID = 10694600.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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19. Farray D, Mirkovic N, Albain KS: Multimodality therapy for stage III non-small-cell lung cancer. J Clin Oncol; 2005 May 10;23(14):3257-69
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  • [Title] Multimodality therapy for stage III non-small-cell lung cancer.
  • The treatment of stage III non-small-cell lung cancer has evolved over the last two decades, with combined-modality therapy the current standard of care.
  • As a result, intermediate and long-term survival has improved for patients in this common stage category, compared to the poor outcomes achieved with the historical standard of once-daily radiation therapy alone.
  • Chemotherapy plus radiotherapy given concurrently is the optimal treatment for the group of patients with advanced stage III disease.
  • The potential role of a surgical resection following chemotherapy (with or without radiation) in this setting is still controversial.
  • The only subsets for which trimodality treatments are clearly preferred include T4N0-1 disease and superior sulcus tumors.
  • Induction chemotherapy before surgery may yield a survival advantage, although the phase III trials in this area are not conclusive.
  • Given the marked survival benefit from adjuvant chemotherapy after surgery in even earlier stages of non-small-cell lung cancer, the proper sequence of surgery and chemotherapy (before v after surgery) remains an important unresolved question in this subgroup.
  • Furthermore, how to incorporate radiation therapy, as well as whether it should be given at all in this subset of patients, are other important issues actively under study in ongoing trials.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Neoplasm Staging. Randomized Controlled Trials as Topic

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  • [ErratumIn] J Clin Oncol. 2005 Oct 20;23(30):7763
  • (PMID = 15886313.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 72
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20. Miyoshi S, Iuchi K, Nakamura K, Nakagawa K, Maeda H, Ohno K, Nakahara K, Nakano N, Okumura M, Ohta M: Induction concurrent chemoradiation therapy for invading apical non-small cell lung cancer. Jpn J Thorac Cardiovasc Surg; 2004 Mar;52(3):120-6
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  • [Title] Induction concurrent chemoradiation therapy for invading apical non-small cell lung cancer.
  • OBJECTIVE: Although non-small cell lung cancer (NSCLC) involving the superior sulcus has been generally treated with radiation therapy (RT) followed by surgery, local recurrence is still a big problem to be solved.
  • We investigated a role of induction therapy, especially induction concurrent chemoradiation therapy (CRT), on the surgical results of this type of NSCLC.
  • Ten patients (57 +/- 8 years) received surgery alone, 9 (55 +/- 13 years) received RT (42 +/- 7 Gy) followed by surgery and 11 (51 +/- 9 years) received cisplatin based chemotherapy and RT (47 +/- 5 Gy) as an induction therapy.
  • Univariate analysis demonstrated that curability (yes versus no: p = 0.027) and induction therapy (surgery alone and RT versus CRT: p = 0.0173) were significant prognostic factors.
  • Multivariate analysis revealed that only induction therapy (p = 0.0238) was a significant prognostic factor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Neoadjuvant Therapy
  • [MeSH-minor] Chi-Square Distribution. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Proportional Hazards Models. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 15077845.001).
  • [ISSN] 1344-4964
  • [Journal-full-title] The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi
  • [ISO-abbreviation] Jpn. J. Thorac. Cardiovasc. Surg.
  • [Language] eng
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  • [Publication-country] Japan
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21. Scott WJ, Howington J, Movsas B, American College of Chest Physicians: Treatment of stage II non-small cell lung cancer. Chest; 2003 Jan;123(1 Suppl):188S-201S
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  • [Title] Treatment of stage II non-small cell lung cancer.
  • Based on clinical assessment alone, patients with stage II non-small cell lung cancer (NSCLC) comprise only 5% of all patients with NSCLC.
  • The extent of the data available regarding treatment of each of these different groups is therefore limited.
  • Studies of adjuvant therapy after complete resection of stage II NSCLC are an important exception to this generalization, since data from large, randomized studies of adjuvant radiation therapy, chemotherapy, or a combination of the two are available for analysis.
  • Superior sulcus tumors are discussed elsewhere in these guidelines.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery. Mediastinal Neoplasms / secondary. Mediastinal Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy / methods. Humans. Lymphatic Metastasis. Neoplasm Staging. Pneumonectomy / methods. Radiotherapy, Adjuvant. Survival Analysis


22. Chapelier A, Fadel E, Macchiarini P, Lenot B, Le Roy Ladurie F, Cerrina J, Dartevelle P: Factors affecting long-term survival after en-bloc resection of lung cancer invading the chest wall. Eur J Cardiothorac Surg; 2000 Nov;18(5):513-8
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  • [Title] Factors affecting long-term survival after en-bloc resection of lung cancer invading the chest wall.
  • OBJECTIVE: Several reports emphasize the importance of en-bloc resection as the optimal surgical treatment of lung cancer with chest wall invasion.
  • METHODS: Between 1981 and 1998, 100 patients (90 male; ten female), with a median age of 60 years (36-84), underwent radical en-bloc resection of non-small cell lung cancer (NSCLC) with chest wall involvement.
  • Patients with superior sulcus tumors invading the thoracic inlet were excluded from this series.
  • Lung resection included 73 lobectomies, two bilobectomies, 18 pneumonectomies and seven segmentectomies.
  • Sixty-three patients received postoperative radiotherapy and 12 received chemotherapy.
  • The role of induction chemotherapy for tumors with poor prognosis should be investigated.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Carcinoma / mortality. Carcinoma / surgery. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / surgery. Lung Neoplasms / mortality. Lung Neoplasms / surgery. Pneumonectomy / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Combined Modality Therapy. Female. Follow-Up Studies. Hospital Mortality. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Predictive Value of Tests. Prognosis. Proportional Hazards Models. Risk Factors. Survival Analysis. Treatment Outcome

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  • (PMID = 11053809.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] ENGLAND
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23. Gallo AE, Donington JS: The role of surgery in the treatment of stage III non-small-cell lung cancer. Curr Oncol Rep; 2007 Jul;9(4):247-54
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  • [Title] The role of surgery in the treatment of stage III non-small-cell lung cancer.
  • Stage III, locally advanced non-small-cell lung cancer represents an incredibly heterogeneous group of patients.
  • The majority of patients are treated with curative intent, but optimal therapy is controversial and the role of surgery is not well defined.
  • The exceptions are selected patients with tumor stage 4 (T4) by virtue of a satellite nodule or those with isolated invasion of the spine, superior sulcus, carina, or vena cava.
  • Patients with micrometastatic disease and single-station nodal involvement have the greatest chance for cure, and surgery appears to play a significant role in their treatment.
  • Patients with bulky multistation disease are frequently not amenable to complete resection and may be best approached with definitive chemotherapy and radiation.
  • In addition, the ability to sterilize mediastinal lymph nodes with induction therapy correlates strongly with survival following resection, but the ideal induction regime that balances the safety and efficacy has yet to be determined.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Humans. Lymphatic Metastasis / pathology. Neoplasm Staging

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  • [Cites] Chest. 2003 Jan;123(1 Suppl):137S-146S [12527573.001]
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  • [Cites] J Clin Oncol. 1995 Aug;13(8):1880-92 [7636530.001]
  • [Cites] Ann Thorac Surg. 1997 Nov;64(5):1402-7; discussion 1407-8 [9386711.001]
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  • (PMID = 17588348.001).
  • [ISSN] 1523-3790
  • [Journal-full-title] Current oncology reports
  • [ISO-abbreviation] Curr Oncol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 47
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24. Ettinger DS: An overview of Eastern Cooperative Oncology Group stage III non-small cell lung cancer studies. Semin Oncol; 2005 Apr;32(2 Suppl 3):S109-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An overview of Eastern Cooperative Oncology Group stage III non-small cell lung cancer studies.
  • The Eastern Cooperative Oncology Group conducts phase II and III trials for the treatment of resectable and unresectable stage III non-small cell lung cancer, and also participates in a number of Intergroup studies.
  • For resectable disease, the Eastern Cooperative Oncology Group is participating in a phase III prospective randomized, double-blind, placebo-controlled trial of the epidermal growth factor receptor antagonist gefitinib (ZD1839), a phase II trial for superior sulcus tumors of induction chemoradiotherapy with cisplatin/etoposide followed by surgical resection, followed by docetaxel.
  • For unresectable disease, a phase III trial of carboplatin, paclitaxel, and thoracic radiation therapy with or without thalidomide is underway.
  • Proposed studies include a feasibility phase II study of chemotherapy/hyperfractionated accelerated radiation therapy (HART) + cetuximab (an antibody specific for epidermal growth factor receptor) and a phase II trial of pharmcogenomics-directed adjuvant chemotherapy for completely resected non-small cell lung cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Non-Small-Cell Lung / therapy. Intracellular Signaling Peptides and Proteins / therapeutic use. Lung Neoplasms / therapy. Quinazolines / therapeutic use. Receptor, Epidermal Growth Factor / antagonists & inhibitors
  • [MeSH-minor] Clinical Trials as Topic. Combined Modality Therapy. Humans

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  • (PMID = 16015545.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Intracellular Signaling Peptides and Proteins; 0 / Quinazolines; 0 / protein kinase modulator; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; S65743JHBS / gefitinib
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25. Vandenbroucke E, De Ryck F, Surmont V, van Meerbeeck JP: What is the role for surgery in patients with stage III non-small cell lung cancer? Curr Opin Pulm Med; 2009 Jul;15(4):295-302
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] What is the role for surgery in patients with stage III non-small cell lung cancer?
  • PURPOSE OF REVIEW: Locally advanced non-small cell lung cancer (NSCLC) represents a therapeutic challenge.
  • Although combined modality has become the standard treatment in stage III NSCLC, the role of surgery in it remains controversial.
  • This review will address recent evidence on the potential role of surgery in either superior sulcus tumors, T4N0-1 tumors with central extension multifocal tumors with nodule(s) in the same lobe, or stage III disease with mediastinal lymph node involvement.
  • RECENT FINDINGS: Two recent phase 2 trials, exploring surgical resection preceded by induction chemoradiotherapy for tumors of the superior sulcus, have reported an impressive survival with acceptable mortality rate.
  • For subsets of T4 NSCLC with central extension or with satellite nodule(s) in the primary lobe, cumulative data suggest that these tumors behave differently than other stage IIIB tumors and might benefit from upfront surgery, possibly followed by postoperative chemotherapy and/or radiotherapy.
  • Whenever clinical mediastinal lymph node invasion is present, surgery after induction treatment is not proven superior to radiotherapy, and is best restricted to clinical trials.
  • SUMMARY: Combined modality treatment is the standard of care for locally advanced NSCLC and the optimal role for surgery remains a challenging issue for the clinicians.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Humans. Neoplasm Staging

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  • (PMID = 19465855.001).
  • [ISSN] 1531-6971
  • [Journal-full-title] Current opinion in pulmonary medicine
  • [ISO-abbreviation] Curr Opin Pulm Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 38
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26. Vincent L, Guibert B, Mornex F, Grangeon V, Harf R, Gormand F, Pacheco Y: [Neoadjuvant chemoradiotherapy and peroperative radiotherapy for non-small-cell lung cancer of the apex. A study of 5 cases]. Rev Pneumol Clin; 2001 Sep;57(4):271-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Neoadjuvant chemoradiotherapy and peroperative radiotherapy for non-small-cell lung cancer of the apex. A study of 5 cases].
  • The management of superior sulcus tumors with Pancoast 's syndrome is not well defined, especially in view of their low frequency.
  • Even if surgery performed by "en bloc" resection of the tumor and the chest wall is recommended, neoadjuvant treatment could have a potential benefit on the resecability and pain control.
  • We report five cases of Pancoast tumors (NSCLC), treated by radiotherapy and chemotherapy before surgery.
  • A regimen with radiotherapy (50 Gy) and chemotherapy (cisplatinum + etoposide) was initially performed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Intraoperative Care / methods. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Neoadjuvant Therapy / methods
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Etoposide / administration & dosage. Feasibility Studies. Female. Humans. Male. Middle Aged. Neoplasm Staging. Pain / diagnosis. Pain / etiology. Pancoast Syndrome / etiology. Patient Selection. Pneumonectomy. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome


27. Roy MS, Donington JS: Management of locally advanced non small cell lung cancer from a surgical perspective. Curr Treat Options Oncol; 2007 Feb;8(1):1-14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of locally advanced non small cell lung cancer from a surgical perspective.
  • Optimal therapy for this group is controversial and the role of surgery is not clearly defined.
  • There have been several randomized trials over the past three decades that have helped to guide our decision-making.
  • In patients with T3N1 tumors, surgery is the primary treatment and there is now evidence for the use of adjuvant chemotherapy.
  • Exceptions to this are selective T4 tumors by virtue of a satellite nodule or those with isolated invasion of the spine, superior sulcus, carina or vena cava.
  • There is an increasing understanding of the importance of multi-modality therapy for N2 disease, but the exact role and timing of chemotherapy, radiation and surgery remains unclear.
  • Patients with micometastatic disease and single station nodal involvement have the greatest chance for cure and surgery has a significant role in their treatment.
  • In addition, the ability to sterilize mediastinal lymph nodes with induction therapy correlates strongly with survival.
  • However, the ideal form and timing of induction therapy has yet to be determined.
  • Bulky multi-station disease is frequently not amenable to surgery and is best approached with definitive chemotherapy and radiation.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Carcinoma, Non-Small-Cell Lung / therapy. General Surgery / methods. Lung Neoplasms / surgery. Lung Neoplasms / therapy. Medical Oncology / methods
  • [MeSH-minor] Clinical Trials as Topic. Combined Modality Therapy / methods. Humans. Lymphatic Metastasis. Neoplasm Metastasis

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  • (PMID = 17634831.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 62
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