Lee, Jin Gu; Cho, Byoung Chul; Bae, Mi Kyung; Lee, Chang Young; Park, In Kyu; Kim, Dae Joon; Chung, Kyung Young
The Annals of thoracic surgery
2011Feb ; 91 ( 2 ) :344-8.
PMID : 21256264
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Lee, Jin Gu -
Cho, Byoung Chul -
Bae, Mi Kyung -
Lee, Chang Young -
Park, In Kyu -
Kim, Dae Joon -
Chung, Kyung Young -
ABSTRACT
BACKGROUND: Although the survival benefit of adjuvant chemotherapy for nonsmall-cell lung cancer has been proved, 50% to 86% of patients received all planned cycles of chemotherapy. A thoracoscopic procedure may enable more effective administration of adjuvant chemotherapy than a thoracotomy. However, a well-balanced comparison is lacking.
METHODS: Patients who underwent pulmonary resection and received platinum-based double adjuvant chemotherapy for nonsmall-cell lung cancer were identified from a prospective database. A propensity score-matched analysis was performed to obtain a well-balanced comparison between thoracoscopy and thoracotomy to determine compliance of adjuvant chemotherapy.
RESULTS: Seventy-four patients (group A) with thoracoscopy and 278 patients with thoracotomy received adjuvant chemotherapy. Through 1:1 matching, 74 patients (group B) were selected from the thoracotomy group. A higher percentage of group A received four cycles of the planned adjuvant chemotherapy (95.9% versus 82.4%, p = 0.015). There was a trend toward better compliance in group A with four cycles of adjuvant chemotherapy without reduced dose (83.8% versus 73.0%, p = 0.162), and four cycles of adjuvant chemotherapy without delayed or reduced dose (70.3% versus 62.2%, p = 0.385).
CONCLUSIONS: Thoracoscopy showed better compliance with adjuvant chemotherapy after pulmonary resection for nonsmall-cell lung cancer. CI - Copyright A??2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Adenocarcinoma/drug therapy/epidemiology/pathology/surgery; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use; Carcinoma, Non-Small-Cell Lung/*drug therapy/epidemiology/pathology/*surgery; Chemotherapy, Adjuvant; Comorbidity; Disease-Free Survival; Female; Humans; Incidence; Lung/surgery; Lung Neoplasms/*drug therapy/epidemiology/pathology/*surgery; Male; Middle Aged; Neoplasm Staging; Neoplasms, Squamous Cell/drug therapy/epidemiology/pathology/surgery; *Patient Compliance; Retrospective Studies; Sex Distribution; Smoking/epidemiology; Thoracoscopy; Thoracotomy; Treatment Outcome
MESH
Adenocarcinoma/drug therapy/epidemiology/pathology/surgery, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/*therapeutic use, Carcinoma, Non-Small-Cell Lung/*drug therapy/epidemiology/pathology/*surgery, Chemotherapy, Adjuvant, Comorbidity, Disease-Free Survival, Female, Humans, Incidence, Lung/surgery, Lung Neoplasms/*drug therapy/epidemiology/pathology/*surgery, Male, Middle Aged, Neoplasm Staging, Neoplasms, Squamous Cell/drug therapy/epidemiology/pathology/surgery, *Patient Compliance, Retrospective Studies, Sex Distribution, Smoking/epidemiology, Thoracoscopy, Thoracotomy, Treatment Outcome
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