Artículos Originales |
Introducción.- Al diagnóstico, cerca del 20% de los pacientes con carcinoma no microcítico de pulmón presentan enfermedad localmente avanzada. Por ello realizamos un abordaje interdisciplinario basado en la quimioterapia y radioterapia neoadyuvante, seguidas de cirugía, para determinar la respuesta y la seguridad de este tratamiento en estos pacientes. Palabras Claves: Tratamiento neoadyuvante, cáncer no microcítico de pulmón, radioquimioterapia concurrente con platino.
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Abstract: | |
Introduction.- At diagnosis, closer to 20% of patients with non small-cell carninoma of the lung (NSCLC) present locally advanced disease. For this reason we carry out an interdisciplinary treatment based on neoadjuvant chemotherapy and radiation therapy, followed by surgery with the objective of determining the response and the safety of this treatment in such patients.
Material and Methods.- A descriptive longitunidal prospective study in 62 patients who received
cisplatin based concomitant chemoradiotherapy with a total dosage of 60 to 70 Gy with neoadjuvant intention during the betwee january 2000 and December of 2008 within the Suregery Service of the INOR. Exploratory thoracotomy was done. It was calculated the association between the qualitative variables ( sex, initial stage, histology and localization of the tumor) and the variables wich defined the local control of the disease ( the radiographic and pathologic response and resectability of the tumor as well as the association between the latter.
Results.- 62 patients with locally advanced NSCLC were evaluated with clinical (c) T2N2 disease, cT3NO- N1, cT4 (without malgnant pleural effusion) cT3 o cT4 and mediastinal disease cN2. Complete radiographic responde was achieved in 17.7%. There was progression of the disease in five patients 8% and 39 (62%) who had pathological reduction. Pathologycal sterilization was achieved in the lymphatic groups in 26 (68.4%)There was postsurgical morbidity in 24% of the patients.
Conclusions.- The naoadjuvant treatment was usefull and sure when the radiologic and pathologic response was induced as well as increasing the percentage of resectability and showed acceptable toxicity.
Key word.- Neoadjuvant tratment, non small - cell carcinoma of the lung, cisplatin based concomitant chemoradiotherapy.
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Autor(es) : Dr. Fernando Areces Delgado, Dr. Juan C. Collado, Dra. Nuria Mederos,
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