Improved survival associated with neoadjuvant chemoradiation and surgery vs other means of treatment for NSCLC N2 patients (clinical stage IIIa and IIIb)

Introduction: This study examines whether neoadjuvant chemoradiationtherapy combined with surgery improves survival rates when compared with other treatment strategies. Methods: We analysed 225 NSCLC patients with positive N2-nodes, who received various treatment between 2009 and 2014. Median follow-up and overall survival (OS) were defined from date of diagnosis to last known contact. Overall survival was estimated using Kaplan-Meier methods. Results: Mean age was 70 +/- 10 years. 13 patients received only radiationtherapy (RT), 36 patients neoadjuvant chemoradiotherapie and surgery (CRT-S), 38 patients were primary operated and received adjuvant chemoradiotherapie (S-CRT), 120 patients received chemotherapy (CTX) and 18 patients received best supportive care (BSC). Median follow-up was 15.1 month. Overall survival is represented in figure 1. Median overall survival in CRT-S group was 522.5 days (average 763 days), in CTX group was 283 days (average 424 days), in S-CRT group was 287.5 days (average 515.8 days), in RT group was 318 days (average 370.8 days), in BSC group was 12.5 days (average 50 days). Conclusion: This study demonstrates that therapy of choice for NSCLC patients with N2 positive nodes (both IIIA and IIIB clinical stage) is neoadjuvant chemoradiotherapy followed by radical surgery for improved overall survival.