Abstract
Non-small cell lung cancer invading the chest wall neighboring the vertebral body is difficult to completely resect because of its anatomical character. We evaluated the results of induction chemo-radiotherapy aiming to achieve the complete resection of cancer tissue. This regimen was carried out in 6 men with a median age of 57 years old. The clinical stage was IIB in 3 cases and IIIA in 3 cases, and the pathological diagnosis was adenocarcinoma in 3 cases and squamous cell carcinoma in 3 cases. Chemotherapy varied, with CDDP+TXT in 3 cases and CDDP+NVR in 3 cases, accompanied by radiotherapy of 40 Gy in 5 cases and 60 Gy in 1 case. Induction treatment was completely carried out in all cases, resulting in stable disease in 4 cases and partial response in 2 cases, followed by complete resection. The pathological efficacy was Ef0 in 1 case, Ef1 in 1 case, Ef2 in 3 cases, and Ef3 in 1 case. Recurrence occurred in 5 cases: 2 marginal recurrences (limited to cases of Ef0 or Ef1), 1 local recurrence (lung), and 2 distant metastases. The median survival time was 19 months and the 3-year survival rate was 22%, with a median follow-up period of 30 months. There is no statistical supporting, but this regimen may effectively reduce the risk of marginal recurrence in cases showing a good pathological response, while extended resection should be an option in cases exhibiting a poor pathological response.
