Multimodality treatment of stage IIIA non-small-cell lung carcinoma

A critical review of the literature and strategies for future research

Gary M. Strauss, Mark Langer, Anthony D. Elias, Arthur T. Skarin, David J. Sugarbaker

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Purpose and Design: Stage IIIA non-small-cell lung carcinoma (NSCLC) is composed of regionally advanced yet potentially resectable disease. Many trials have evaluated a variety of therapeutic strategies. Most have been single-arm phase II trials, although a number of comparative phase III trials have also been performed. This review critically evaluates the existing literature on the treatment of stage IIIA NSCLC, particularly the various multimodality approaches that have been used. Results: A review of the existing literature does not establish the optimal treatment of stage IIIA NSCLC. Although radiation therapy alone remains the most commonly administered therapy for apparently unresectable disease, the status of radiation as a "standard" therapy can be seriously challenged based on existing data. Similarly, although a number of studies have established that surgical resection is clearly feasible in selected patients with stage IIIA disease, the efficacy of surgery also remains to be definitively established. Many studies have explored neoadjuvant chemotherapy, either in conjunction with radiation or surgery, with results that are best described as conflicting and controversial. Conclusions: Without question, randomized phase III trials are required at this time to define what is to be considered optimal treatment. An attempt is made to define the most important questions that should be addressed in future phase III trials. Additionally, a number of study designs are suggested to best answer the therapeutic questions posed.

Original languageEnglish (US)
Pages (from-to)829-838
Number of pages10
JournalJournal of Clinical Oncology
Volume10
Issue number5
StatePublished - 1992
Externally publishedYes

Fingerprint

Non-Small Cell Lung Carcinoma
Therapeutics
Radiation
Radiotherapy
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Multimodality treatment of stage IIIA non-small-cell lung carcinoma : A critical review of the literature and strategies for future research. / Strauss, Gary M.; Langer, Mark; Elias, Anthony D.; Skarin, Arthur T.; Sugarbaker, David J.

In: Journal of Clinical Oncology, Vol. 10, No. 5, 1992, p. 829-838.

Research output: Contribution to journalArticle

Strauss, Gary M. ; Langer, Mark ; Elias, Anthony D. ; Skarin, Arthur T. ; Sugarbaker, David J. / Multimodality treatment of stage IIIA non-small-cell lung carcinoma : A critical review of the literature and strategies for future research. In: Journal of Clinical Oncology. 1992 ; Vol. 10, No. 5. pp. 829-838.
@article{43832335e1ed45a2bd012e97e8f2b458,
title = "Multimodality treatment of stage IIIA non-small-cell lung carcinoma: A critical review of the literature and strategies for future research",
abstract = "Purpose and Design: Stage IIIA non-small-cell lung carcinoma (NSCLC) is composed of regionally advanced yet potentially resectable disease. Many trials have evaluated a variety of therapeutic strategies. Most have been single-arm phase II trials, although a number of comparative phase III trials have also been performed. This review critically evaluates the existing literature on the treatment of stage IIIA NSCLC, particularly the various multimodality approaches that have been used. Results: A review of the existing literature does not establish the optimal treatment of stage IIIA NSCLC. Although radiation therapy alone remains the most commonly administered therapy for apparently unresectable disease, the status of radiation as a {"}standard{"} therapy can be seriously challenged based on existing data. Similarly, although a number of studies have established that surgical resection is clearly feasible in selected patients with stage IIIA disease, the efficacy of surgery also remains to be definitively established. Many studies have explored neoadjuvant chemotherapy, either in conjunction with radiation or surgery, with results that are best described as conflicting and controversial. Conclusions: Without question, randomized phase III trials are required at this time to define what is to be considered optimal treatment. An attempt is made to define the most important questions that should be addressed in future phase III trials. Additionally, a number of study designs are suggested to best answer the therapeutic questions posed.",
author = "Strauss, {Gary M.} and Mark Langer and Elias, {Anthony D.} and Skarin, {Arthur T.} and Sugarbaker, {David J.}",
year = "1992",
language = "English (US)",
volume = "10",
pages = "829--838",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "5",

}

TY - JOUR

T1 - Multimodality treatment of stage IIIA non-small-cell lung carcinoma

T2 - A critical review of the literature and strategies for future research

AU - Strauss, Gary M.

AU - Langer, Mark

AU - Elias, Anthony D.

AU - Skarin, Arthur T.

AU - Sugarbaker, David J.

PY - 1992

Y1 - 1992

N2 - Purpose and Design: Stage IIIA non-small-cell lung carcinoma (NSCLC) is composed of regionally advanced yet potentially resectable disease. Many trials have evaluated a variety of therapeutic strategies. Most have been single-arm phase II trials, although a number of comparative phase III trials have also been performed. This review critically evaluates the existing literature on the treatment of stage IIIA NSCLC, particularly the various multimodality approaches that have been used. Results: A review of the existing literature does not establish the optimal treatment of stage IIIA NSCLC. Although radiation therapy alone remains the most commonly administered therapy for apparently unresectable disease, the status of radiation as a "standard" therapy can be seriously challenged based on existing data. Similarly, although a number of studies have established that surgical resection is clearly feasible in selected patients with stage IIIA disease, the efficacy of surgery also remains to be definitively established. Many studies have explored neoadjuvant chemotherapy, either in conjunction with radiation or surgery, with results that are best described as conflicting and controversial. Conclusions: Without question, randomized phase III trials are required at this time to define what is to be considered optimal treatment. An attempt is made to define the most important questions that should be addressed in future phase III trials. Additionally, a number of study designs are suggested to best answer the therapeutic questions posed.

AB - Purpose and Design: Stage IIIA non-small-cell lung carcinoma (NSCLC) is composed of regionally advanced yet potentially resectable disease. Many trials have evaluated a variety of therapeutic strategies. Most have been single-arm phase II trials, although a number of comparative phase III trials have also been performed. This review critically evaluates the existing literature on the treatment of stage IIIA NSCLC, particularly the various multimodality approaches that have been used. Results: A review of the existing literature does not establish the optimal treatment of stage IIIA NSCLC. Although radiation therapy alone remains the most commonly administered therapy for apparently unresectable disease, the status of radiation as a "standard" therapy can be seriously challenged based on existing data. Similarly, although a number of studies have established that surgical resection is clearly feasible in selected patients with stage IIIA disease, the efficacy of surgery also remains to be definitively established. Many studies have explored neoadjuvant chemotherapy, either in conjunction with radiation or surgery, with results that are best described as conflicting and controversial. Conclusions: Without question, randomized phase III trials are required at this time to define what is to be considered optimal treatment. An attempt is made to define the most important questions that should be addressed in future phase III trials. Additionally, a number of study designs are suggested to best answer the therapeutic questions posed.

UR - http://www.scopus.com/inward/record.url?scp=0026636032&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026636032&partnerID=8YFLogxK

M3 - Article

VL - 10

SP - 829

EP - 838

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 5

ER -