The Effect of Neoadjuvant Chemotherapy with 5-Fluorouracil (5-FU), Vinblastine and Cisplatin (FVP) for Stage III Non-Small Cell Lung Cancer (NSCLC).
- Author:
Jung Il WON
1
;
Jong Ho CHUN
;
Hyeong Jun KIM
;
Moon Suk JO
;
Dong Kyu KIM
;
Young Tae KWAK
;
Jung Suk KIM
;
Soo Jeon CHOI
;
Sung Rok KIM
Author Information
1. Department of Internal Medicine, Inje University Sanggye Paik Hospital, Korea.
- Publication Type:Original Article
- Keywords:
5-Fluorouracil;
Vinblastine;
Cisplatin;
Neoadjuvant chemotherapy;
Non-small cell lung cancer
- MeSH:
Agranulocytosis;
Carcinoma, Non-Small-Cell Lung*;
Cisplatin*;
Drug Therapy*;
Female;
Fluorouracil*;
Humans;
Male;
Prognosis;
Radiotherapy;
Thorax;
Thrombocytopenia;
Vinblastine*
- From:Journal of the Korean Cancer Association
1997;29(5):807-815
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: As the prognosis of stage III NSCLC is still poor with or without operation, we conducted a phase II trial of neoadjuvant chemotherapy (CHT) with 5-FU, vinblastine, cisplatin prior to surgery to determine the effect on resectability and survival. MATERIALS AND METHOD: Patients (pt) received 5-FU 500mg/m2/12 hours continuous infusion for 36 hours, vinblastine 3mg/m2/day iv bolus day 1 and day 2, and cisplatin 75mg/m2 iv day 1 every 3 weeks. This regimen was given for 2 cycles. When the tumor was responsive (stable disease or better), 1 or 2 more cycles of the CHT were given, followed by operation when totally resectable on chest CT/MRI, then 3 more cycles of the CHT to finish the treatment; when the tumor was neither responsive nor resectable after 3rd or 4th CHT, radiotherapy was started. RESULT: Twenty nine pt were enrolled and 26 pt have been evaluable so far. Age ranged from 32 to 79 (median 59 years); 23 were male, 3 female. Total of 108 cycles were given (mean 4.2). There were 4 partial remissions out of 6 IIIAs (67%) and 10 out of 20 IIIBs (50%), with overall response rate of 53.8%; down staging was noted in 9 patients (34.6%). 9 pt (34.6%) underwent curative resection successfully; 4 out of 6 IIIAs (67%) and 5 out of 20 IIIBs (25.0%); 1 patient refused operation. Median survival was 31.3 months for 9 pt with operation, and that of all patients was 14.2 months. Radiation was given to 9 pt, resulting in 3 partial remissions (PR), 3 stable diseases (SD), 3 progressive diseases (PD). Serious (WHO grade> or =3) toxicities were nausea/emesis in 2.8%, granulocytopenia in 26.9% and thrombocytopenia in 2.8%. CONCLUSION: This treatment modality seemed to be effective, encouraging further phase III study for better determination of its role.