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Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non–small cell lung cancer

The Journal of Thoracic and Cardiovascular Surgery Aug 14, 2020

Donington JS, Paulus R, Edelman MJ, et al. - In resectable N2+ stage IIIA non–small cell lung cancer, researchers evaluated early outcomes of anatomic resection after induction therapy with platinum-based chemotherapy and full-dose thoracic radiation. With the primary endpoint of mediastinal node sterilization after concurrent full-dose chemoradiotherapy, two prospective trials were recently performed by NRG Oncology among patients with resectable N2+ stage IIIA non–small cell lung cancer. Patients in one study were randomly assigned 2:1 to receive weekly panitumumab + chemoradiotherapy or only chemoradiotherapy during induction. There were 126 enrolled patients, of whom 93 (74%) underwent anatomic resection, 77 had lobectomy, and 16 had extended resection. Findings demonstrated the safety of performing lobectomy after full-dose concurrent chemoradiotherapy in these multi-institutional prospective trials, but extended resections were associated with higher 30- and 90-day  mortality.

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