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EDITORIAL Randomized Controlled Trial of Resection Versus Radiotherapy after Induction Chemotherapy in Stage IIIA-N2 Non-small Cell Lung Cancer Johan Vansteenkiste, MD, PhD,* Daniel Betticher, MD, PhD,† Wilfried Eberhardt, MD,‡ and Paul De Leyn, MD, PhD§ recent article in the Journal of the National Cancer Institute presented results of the AEORTC 08941 study. The main conclusion was that surgical (i.e., chemotherapy and surgical resection) and non-surgical multimodality treatments (chemotherapy and radio- therapy) led to similar 5-year survival rates of approximately 15% among selected patients with stage IIIA-N2 non-small cell lung cancer (NSCLC) with response to induction chemotherapy. This important study must be understood in its appropriate context of patients with unresectable IIIA-N2 disease: induction chemotherapy did not convert unresectable disease into resectable—as illustrated by the 50% incomplete resection rate in the surgery arm—and, not unexpectedly, did not result in better outcome compared with radiotherapy. The crucial term “unresectable” was not clearly defined in the article. In the initial protocol (October 15, 1994), patients were eligible if “judged by the responsible surgeon to have irresectable N2-disease.” This vital criterion was amended to the “guidelines for irresectability” as they are mentioned in the publication on page 443, by an amendment on September
Journal of Thoracic Oncology – Wolters Kluwer Health
Published: Aug 1, 2007
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