Published online Nov 24, 2021. doi: 10.5306/wjco.v12.i11.1047
Peer-review started: March 26, 2021
First decision: June 16, 2021
Revised: June 22, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: November 24, 2021
Processing time: 237 Days and 17.6 Hours
There is no standardized clinical consensus for the evaluation of the surgical specimen in patients with non-small cell lung cancer (NSCLC) who have received neoadjuvant treatment with chemotherapy, radiotherapy, or a combination of both.
Following the recently published recommendations by the International Association for the Study of Lung Cancer (IASLC) for the pathological evaluation of tumors and lymph nodes, we analyzed the radiological and pathological response of patients treated with neoadjuvant chemotherapy or chemoradiotherapy.
Our intention was to contribute to the IASLC recommendations with clinical results that reflect the differences in the response to neoadjuvant therapy with chemoradiotherapy vs chemotherapy.
We performed a retrospective analysis of patients with resectable stage III NSCLC treated with chemotherapy or chemoradiotherapy as neoadjuvant treatment followed by surgery. All histological samples were examined to assess pathological response by the percentage of viable cells in the tumor and the resected lymph nodes.
We observed better results in the chemoradiotherapy group for both radiological and pathological response, with a lower risk of persistence of cancer cells in the tumor and resected lymph nodes, and with a greater probability of achieving downstaging.
In this study we observed a greater response to neoadjuvant treatment when adding radiotherapy to chemotherapy. We believe that this could contribute to improving the management of this group of patients.
Longer follow-up of these patients is necessary to establish a relationship between pathological response and clinical outcomes.