PROGNOSTIC FACTORS IN COMPLEX TREATMENT WITH NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH NON-SMALL CELL LUNG CANCER WITH MEDIASTINAL LYMPH NODE INVOLVEMENT (N2)

Objective. To determine possible prognostic factors in patients with NSCLC with mediastinal lymph node involvement (N2) passed complex treatment with neoadjuvant polychemotherapy (nPCT), surgery and adjuvant polychemotherapy (aPCT), form prognostic groups and give treatment recommendations.

Material and methods. The study included 38 patients with stage III NSCLC with mediastinal lymph node involvement who were treated at the N.N. Alexandrov National Cancer Centre from 2004 to 2019. Complex treatment included
2 courses of nPCT (cisplatin 100 mg / m2 on day 1 and vinorelbine 30 mg / m2 on days 1 and 8) with an interval between courses of 21 days, followed by restaging and surgery followed by aPCT according to a similar scheme.

Results. Using univariate and multivariate Cox regression analysis significant prognostic factors were identified:
1. Complete response of the tumor and / or affected mediastinal lymph nodes according to RECIST 1.1 to nPCT. 2. The level of the leukocytal intoxication index. Prognostic groups have been formed. The favorable prognostic group corresponds to an overall 5-year survival rate of 62.6 ± 10.1%, while patients in the unfavorable group do not survive 26 months
(p = 0.0001).

Conclusion. After nPCT and the division of patients with stage III (N2) NSCLC into a prognostic groups chemoradiation should be recommended in the group with a poor prognosis and radical surgery followed by PCT in the group with a favorable prognosis.

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Автор(ы): E. Yu. Demidchik, V.P. Kurchyn