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According to results published in the British Journal of Cancer, chemotherapy following surgery appears to improve survival among patients with Stage I non–small cell lung cancer (NSCLC), but may not improve survival among patients with Stages II-IIIA NSCLC.

Lung cancer remains the leading cause of cancer-related death in the United States. Death rates are largely due to the fact that the majority of lung cancers are not detected until they have spread from their site of origin.

Standard treatment for patients with lung cancer that has not spread outside of the lungs or to nearby lymph nodes typically consists of surgery, chemotherapy, radiation therapy, and/or targeted therapy. Optimal therapeutic regimens for different stages of NSCLC, as well as for patients with differing characteristics, continues to be evaluated.

Adjuvant chemotherapy refers to chemotherapy administered following surgery. Adjuvant chemotherapy is intended to kill any remaining cancer cells in the body, even those that may be undetectable following surgery. Adjuvant chemotherapy for patients with early NSCLC has become generally accepted as a treatment strategy in the United States. However, results from trials have not consistently demonstrated improved survival with this treatment approach.

Researchers from Japan recently conducted a clinical trial to further evaluate adjuvant chemotherapy in the treatment of patients with early NSCLC. The trial included two groups of patients: those with Stage I NSCLC and those with Stages II-IIIA NSCLC.

Patients with Stage I NSCLC (cancer not spread from site of origin) had had their cancer completely removed by surgery. They were then treated with the adjuvant chemotherapy combination referred to as UFT (uracil and tegafur) or with no further therapy (observation group).

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Patients with Stages II-IIIA NSCLC (cancer spread from site of origin to nearby lymph nodes) had also had their cancer completely surgically removed. They were then treated with Platinol® (cisplatin) and Eldisine® (vindesine) and one year of UFT or with no further treatment (observation group).

  • Patients with Stage I cancer treated with UFT had a survival rate of 74.2% at eight years, compared with 57.6% for those in the observation group.
  • There were no differences in outcomes among patients with Stages II-IIIA cancer whether they received chemotherapy or no further therapy following surgery.

The researchers concluded that adjuvant chemotherapy appears to significantly improve survival among patients with Stage I NSCLC, but does not appear to provide improvements for patients with Stages II-IIIA NSCLC. However, these findings are not definitive because all trials have not demonstrated consistent results.

Patients with any stage of NSCLC should speak with their physician regarding their individual risks and benefits of all treatment options.

Reference: Nakagawa K, Tada H, Akashi A, et al. Randomised study of adjuvant chemotherapy for completely resected p-stage I-IIIA non-small cell lung cancer. British Journal of Cancer . 2006;95:817-821.

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