Cisplatin-Based Adjuvant Chemotherapy in Patients with Completely Resected Non–Small-Cell Lung Cancer

• Published in: The New England journal of medicine Vol. 350; no. 4; pp. 351 - 360
• Main Authors: Arriagada, Rodrigo, Bergman, Bengt, Dunant, Ariane, Le Chevalier, Thierry, Pignon, Jean-Pierre, Vansteenkiste, Johan
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 22.01.2004
• Subjects: Adult; Aged; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - radiotherapy; Carcinoma, Non-Small-Cell Lung - surgery; Chemotherapy; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Cisplatin - adverse effects; Clinical trials; Disease-Free Survival; Etoposide - administration & dosage; Humans; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Lung Neoplasms - surgery; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Neoplasm Staging; Pharmacology. Drug treatments; Pneumology; Survival Rate; Systematic review; Tumors of the respiratory system and mediastinum; Vinblastine - administration & dosage; Vinblastine - analogs & derivatives; Vindesine - administration & dosage; Antineoplastic agent; Human; Lung disease; Respiratory disease; Indication; Malignant tumor; non-small cell lung carcinoma; Cisplatin; Alkylating agent; Chemotherapy; Treatment; Bronchus disease; Adjuvant; Platinum II Complexes
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa031644

This large international trial, conducted in 33 countries, showed that postoperative cisplatin-based chemotherapy improved overall survival among patients with completely resected non–small-cell lung cancer. The benefit was small but statistically significant. Small improvements in the survival rate stand to benefit many. Worldwide, lung cancer accounts for the largest number of new cases of cancer and of deaths from cancer annually. 1 Complete surgical resection, whenever feasible, is generally recognized as the most effective initial treatment for non–small-cell lung cancer. Despite several randomized trials, adjuvant treatment has not been shown to benefit patients who have undergone complete resection, and prolonged adjuvant treatment with alkylating agents 2 or with radiotherapy 3 in patients with early-stage disease has even had deleterious effects on long-term survival. A meta-analysis 2 suggested that cisplatin-based adjuvant chemotherapy could yield an absolute overall survival advantage of 5 percent at five years. Several cooperative . . .