Long-term survival (LTS) and competing risks within a prospective multi center German randomized trial comparing induction chemotherapy (CTx) followed by concurrent (cc) chemoradiation (CTx/RTx) plus surgery (SURG; TRIMODALITY) supplemented by PCI versus local treatment (Tx) alone (SURG + RTx) in operable IIIA NSCLC.

7042 Background: we have already reported cumulative probability (prob) of brain relapse as first site of failure within our randomized trial that investigated TRIMODALITY + prophylactic cranial irradiation (PCI) versus SURG + RTx alone in operable IIIA NSCLC (Pottgen, JCO 2007). Here we report LTS for these arms, look for exploratory subgroups and investigate competing risks. Methods: Pts with histopathologically (mediastinoscopy) proven operable IIIA (1-2 LN involved, no clinical N2, no bulky/extranodal disease, central T3N0-1, WHO 0,1) NSCLC were stratified (TN-group, center) and randomized. Arm B received three CTx cycles cis (60 mg/m2 d 1+7 or 8) and eto (150 mg/m2 d 3,4,5) qd 22. This was followed by cc CTx/RTx including cis 50 mg/m2 d 2 + 9 and eto 100 mg/m2 d 4-6 cc with 45 Gy (1.5 Gy bid). 3-5 weeks after end of RTx SURG was performed if possible and PCI given thereafter. Arm A had local treatment alone (SURG + RTx) and no PCI. Results: Pts accrual 1/95 to 10/01; eligible 106/112 randomized; Pts ...