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Cited by 705

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Randomized Controlled Trial of Resection Versus Radiotherapy After Induction Chemotherapy in Stage IIIA-N2 Non-Small-Cell Lung Cancer

Open access
van Meerbeeck, J. P., Kramer, G. W. P. M., Van Schil, P. E. Y., Legrand, C., Smit, E. F., Schramel, F., Tjan-Heijnen, V. C., Biesma, B., Debruyne, C., van Zandwijk, N., Splinter, T. A. W., Giaccone, G.·2007·JNCI Journal of the National Cancer Institute

Abstract

BACKGROUND: Induction chemotherapy before surgical resection increases survival compared with surgical resection alone in patients with stage IIIA-N2 non-small-cell lung cancer (NSCLC). We hypothesized that, following a response to induction chemotherapy, surgical resection would be superior to thoracic radiotherapy as locoregional therapy. METHODS: Selected patients with histologic or cytologic proven stage IIIA-N2 NSCLC were given three cycles of platinum-based induction chemotherapy. Responding patients were subsequently randomly assigned to surgical resection or radiotherapy. Survival curves were estimated using Kaplan-Meier analyses from time of randomization. RESULTS: Induction chemotherapy resulted in a response rate of 61% (95% confidence interval [CI] = 57% to 65%) among the 579 eligible patients. A total of 167 patients were allocated to resection and 165 to radiotherapy. Of the 154 (92%) patients who underwent surgery, 14% had an exploratory thoracotomy, 50% a radical resection, 42% a pathologic downstaging, and 5% a pathologic complete response; 4% died after surgery. Postoperative radiotherapy was administered to 62 (40%) of patients in the surgery arm. Among the 154 (93%) irradiated patients, overall compliance to the radiotherapy prescription was 55%, and grade 3/4 acute and late esophageal and pulmonary toxic effects occurred in 4% and 7%; one patient died of radiation pneumonitis. Median and 5-year overall survival for patients randomly assigned to resection versus radiotherapy were 16.4 versus 17.5 months and 15.7% versus 14%, respectively (hazard ratio = 1.06, 95% CI = 0.84 to 1.35). Rates of progression-free survival were also similar in both groups. CONCLUSION: In selected patients with pathologically proven stage IIIA-N2 NSCLC and a response to induction chemotherapy, surgical resection did not improve overall or progression-free survival compared with radiotherapy. In view of its low morbidity and mortality, radiotherapy should be considered the preferred locoregional treatment for these patients.

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Metadata

Authors
van Meerbeeck, J. P., Kramer, G. W. P. M., Van Schil, P. E. Y., Legrand, C., Smit, E. F., Schramel, F., Tjan-Heijnen, V. C., Biesma, B., Debruyne, C., van Zandwijk, N., Splinter, T. A. W., & Giaccone, G.
Venue
JNCI Journal of the National Cancer Institute
Published
2007-03-20
Volume
99
Issue
6
Pages
442-450
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
OpenAlex
W1954745527
Cited by
705
References
30
FWCI
38.80
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Randomized Controlled Trial of Resection Versus Radiotherapy After Induction Chemotherapy in Stage IIIA-N2 Non-Small-Cell Lung Cancer. https://app.cochat.ai/papers/10.1093/jnci/djk093
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van Meerbeeck, J. P., Kramer, G. W. P. M., Van Schil, P. E. Y., Legrand, C., Smit, E. F., Schramel, F., Tjan-Heijnen, V. C., Biesma, B., Debruyne, C., van Zandwijk, N., Splinter, T. A. W., & Giaccone, G. (2007). Randomized Controlled Trial of Resection Versus Radiotherapy After Induction Chemotherapy in Stage IIIA-N2 Non-Small-Cell Lung Cancer. JNCI Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djk093

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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