e17554 Background: The treatment approach of patients with non-small-cell lung cancer (NSCLC) invading the chest wall (stage T3N0M0) is still controversial. The clinical outcome of NSCLC patients with chest wall invasion has remained poor. The purpose of this study was to determine the efficacy and safety of neoadjuvant concurrent chemoradiation therapy followed by surgical resection in NSCLC patients with chest wall invasion. Methods: We retrospectively reviewed medical records of 19 patients with NSCLC invading chest wall (T3N0M0 or T4N0M0), who underwent neoadjuvant concurrent chemoradiation therapy followed by surgical resection between April 2003 and October 2009. Neoadjuvant chemotherapy was administered intravenously at cisplatin 80 mg/m2 on day 1 and vinorelbine 20 mg/m2 on days 1 and 8, q4w, with a maximum of 2 cycles. Radiotherapy directed at the primary tumor invading chest wall was started in cycle 1, at the total dose of 45Gy in 25 fractions. Surgical resection of the tumor was performed 4 to 8 weeks after the completion of neoadjuvant therapy. Results: Patient characteristics included: median age 61 years (range 43-68); Male/Female=17/2; and stage T3N0M0/T4N0M0=18/1. Six patients (32%) had superior sulcus tumors. Neoadjuvant chemoradiation therapy was generally well tolerated. All patients underwent surgical resection, and complete resection was achieved in 18 patients (95%). There were 10 (53%) patients with pathologic complete response. There were no treatment-related deaths. The 3-year disease-free and overall survival rates for all patients were 58% and 81%, respectively, with a median follow-up of 37 months. The 3-year disease-free survival rate was 78% for patients with a pathologic complete response compared with 25% for those who did not achieve a pathologic complete response. Disease progression occurred mainly in distant sites. Conclusions: Neoadjuvant chemotherapy consists of cisplatin-vinorelbine and radiotherapy followed by surgical resection is effective and tolerable in patients with NSCLC invading chest wall (T3N0M0). This treatment approach produces high rates of pathologic complete response.
Primary chest wall chondrosarcomas: results of surgical resection and analysis of prognostic factors
