Preoperative concomitant chemo-radiotherapy in superior sulcus tumour: A mono-institutional experience

Adolfo Favaretto, Giulia Pasello, Lucio Loreggian, Cristiano Breda, Fausto Braccioni, Giuseppe Marulli, Silvia Stragliotto, Cristina Magro, Guido Sotti, Federico Rea

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Abstract

Superior sulcus tumour (SST) is an uncommon neoplasia whose optimal treatment remains controversial. Usually resected after induction RT or treated with definitive chemo-radiotherapy, it has recently aroused more interest because of preoperative chemo-radiotherapy.Treatment consisted of a platinum-based chemotherapy: carboplatin AUC 5 on days 1 and 22, combined with mitomycin-C 8mg/m2 on days 1 and 22, and vinblastine 4mg/m2 on days 1, 8, 22 and 29 (MVC) from 1994 to 1999, or combined with navelbine 25mg/m2 on days 1, 8, 22 and 29 (NC), from 2000 to 2007. Radiotherapy was administered 5 days/week, 30Gy in 10 fractions on days 22-35 (from 1994 to 1996), or 44Gy in 22 fractions on days 22-52 (from 1997 to 2007). Surgery was planned after 2-3 weeks since the completion of radiotherapy.Since 1994, 37 pts were treated with induction chemo-radiotherapy, 1 with induction radiotherapy only. Induction chemotherapy: 16 pts had MVC (43%) and 21 NC (57%); induction radiotherapy: 7 patients treated with MVC had 30. Gy/10F, 9 had 44. Gy/22F; all the patients treated with NC had 44. Gy/22F, but 2 of them did not complete radiotherapy because of early death (after 16. Gy/8F) and toxicity (after 38. Gy/19F). Grade 3-4 haematological toxicity of induction chemo-radiotherapy was found in 13 patients (35%); the most frequent non-haematological toxicities were constipation and oesophagitis. One complete, 18 partial and 8 minimal responses/stable disease were observed. Moreover, 1 progression disease and 1 early death occurred. Surgery: 30 upper lobectomies (17 right, 13 left) and 4 segmentectomies, with chest wall resections, were performed (89% resection rate); 4 pts were not operated. Radical resections were achieved in 74% of the patients, with 5 pathologic complete remissions at resection. Twenty-seven patients (71%) had improvement of shoulder/arm pain. Median progression-free survival was 64 weeks and median survival was 148 weeks. The 5-year overall and progression-free survivals were 40% and 29%, respectively.In the multimodality treatment of SST, concurrent carboplatin-based chemotherapy plus radiotherapy were active and feasible without major toxicities. This resulted in high resectability rate and favourable progression-free and overall survival rates.

Original languageEnglish
Pages (from-to)228-233
Number of pages6
JournalLung Cancer
Volume68
Issue number2
DOIs
Publication statusPublished - May 2010

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Keywords

  • Carboplatin-based chemotherapy
  • Concomitant chemo-radiotherapy
  • NSCLC
  • Pancoast tumour
  • Preoperative treatment
  • Superior sulcus tumour

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Favaretto, A., Pasello, G., Loreggian, L., Breda, C., Braccioni, F., Marulli, G., Stragliotto, S., Magro, C., Sotti, G., & Rea, F. (2010). Preoperative concomitant chemo-radiotherapy in superior sulcus tumour: A mono-institutional experience. Lung Cancer, 68(2), 228-233. https://doi.org/10.1016/j.lungcan.2009.06.022