Pathological response to neoadjuvant therapy with chemotherapy vs chemoradiotherapy in stage III NSCLC-contribution of IASLC recommendations

Table 1 Patient characteristics, n (%)

	RTCh	Ch	P value
	(n = 40)	(n = 27)
Age	60 (54-67)	67 (62-73)	0.32
Gender			0.29
Male	26 (65)	21 (77.8)
Performance status			0.21
ECOG 0	7 (17.5)	5 (18.5)
ECOG 1	33 (82.5)	20 (74.1)
ECOG 2	0	2 (7.4)
Smoking habit			0.48
Yes	20 (50)	15 (55.6)
No	2 (5)	3 (11.1)
Former smoker	18 (45)	9 (33.3)
Tumor localization			0.33
Apex	7 (17.5)	1 (3.7)
Right upper lobe	13 (32.5)	13 (48.1)
Right lower lobe	6 (15)	2 (7.4)
Left upper lobe	12 (30)	9 (33.3)
Left lower lobe	2 (5)	2 (7.4)
Histology			0.28
Adenocarcinoma	25 (62.5)	20 (74.1)
Squamous	13 (32.5)	6 (22.2)
NSCLC1	0	1 (3.7)
Large cell	2 (5)	0
Stage			0.52
IIIA	27 (67.5)	21 (77.8)
IIIB	12 (30)	6 (22.2)
IV	1 (2.5)	0
T			0.08
T1	4 (10)	9 (33.3)
T2	16 (40)	9 (33.3)
T3	10 (25)	7 (25.9)
T4	10 (25)	2 (7.4)
N			0.04
0	5 (12.5)	0
2	34 (85)	27 (100)
3	1 (2.5)	0
Metastasis	1 (2.5)	0	0.59
Nodal station distribution			0.012
N0	6 (15)	0
1N2	12 (30)	19 (70.4)
2N2	2 (5)	1 (3.7)
1N2 + 1N1	13 (32.5)	7 (25.9)
2N2 + 1N1	5 (12.5)	0
1N1 + 1N2 + 1N3	2 (5)	0
Nodal staging method			0.68
EBUS	24 (60)	14 (51.9)
Mediastinoscopy	2 (5)	3 (11.1)
EBUS and mediastinoscopy	8 (20)	6 (22.2)
EUS	1 (2.5)	2 (7.4)
None	5 (12.5)	2 (7.4)

¹Specific histology could not be determined in one patient. Ch: Chemotherapy. ECOG: Eastern Cooperative Group. NSCLC: Non-Small Cell Lung Cancer. RTCh: Radiochemotherapy; EUS: Endoscopic ultrasound; EBUS: Endobronchial ultrasound

Table 2 Chemotherapy regimens, n (%)

	RTCh	Ch
	(n = 40)	(n = 27)
Cisplatin-Etoposide	19 (47.5)	0
Cisplatin-Vinorelbine	14 (35)	6 (22.2)
Cisplatin-Pemetrexed	4 (10)	3 (11.1)
Cisplatin-Docetaxel	0	6 (22.2)
Cisplatin-Gemcitabine	0	2 (7.4)
Carboplatin-Vinorelbine	3 (7.5)	1 (3.7)
Carboplatin-Paclitaxel	0	6 (22.2)
Carboplatin-Pemetrexed	0	1 (3.7)
Carboplatin-Gemcitabine	0	2 (7.4)

Ch: Chemotherapy. RTCh: Radiochemotherapy.

Table 3 Radiological response, n (%)

	RTCh	Ch	P value
	(n = 40)	(n = 27)
Disease progression	1 (2.5)	4 (14.8)	0.025
Stable disease	14 (35)	14 (51.9)
Partial response	25 (62.5)	8 (29.6)
Complete response	0	1 (3.7)

Ch: Chemotherapy. RTCh: Radiochemotherapy.

Table 4 Surgery characteristics, n (%)

	RTCh	Ch	P value
	(n = 40)	(n = 27)
No surgery	5 (12.5)	6 (22.2)
Type of surgery			0.48
Lobectomy	21 (60)	16 (76)
Bilobectomy	3 (8.6)	1 (4.8)
Pneumonectomy	2 (5.7)	1 (4.8)
Lobectomy and vascular reconstruction	1 (2.8)	1 (4.8)
Lobectomy and rib resection	5 (14.3)	1 (4.8)
Lobectomy with rib resection and vertebrectomy	3 (8.6)	0
Segmentectomy with rib resection and vertebrectomy	0	1 (4.8)
Node level dissection			0.26
2N2 + 1N1	4 (11.4)	3 (14.3)
3N2	2 (5.7)	5 (23.7)
3N2 + 1N1	12 (34.3)	7 (33.3)
3N2 + 2N1	5 (14.3)	3 (14.3)
4N2 + 1N1	8 (22.9)	1 (4.8)
4N2 + 2N1	0	1 (4.8)
4N2 + 1N3	2 (5.7)	0
5N2 + 1N1	2 (5.7)	1 (4.8)

Ch: Chemotherapy. RTCh: Radiochemotherapy.

Table 5 Pathological response, n (%)

	RTCh	Ch	P value
	(n = 40)	(n = 27)
No surgery	5 (12.5)	6 (22.2)
Pathological complete response	6 (17.1)	1 (4.8)	0.23
Tumor response1			0.001
0%-10%	19 (54.4)	2 (9.5)
11%-30%	9 (25.7)	2 (9.5)
31%-50%	4 (11.4)	3 (14.3)
51%-70%	2 (5.7)	6 (28.6)
> 70%	1 (2.8)	8 (38.1)
Nodal response1			0.001
0%-10%	30 (85.7)	7 (33.3)
11%-30%	1 (2.8)	0
31%-50%	2 (5.7)	3 (14.3)
51%-70%	0	2 (9.5)
> 70%	2 (5.7)	9 (42.9)
Downstaging	28 (80)	7 (33.3)	0.002

¹According to the percentage of viable cells in the histological study.

Ch: Chemotherapy. RTCh: Radiochemotherapy.

Table 6 Univariate analysis investigating the impact of neoadjuvant therapy radiochemotherapy on the response

	OR	95%CI	P value
Radiological response
Disease progression	Reference
Stable disease	4	0.39-40.42	0.240
Partial response	12.5	1.21-128.61	0.035
Complete response	NA1
Pathological tumor response
0%-10%	Reference
11%-30%	0.474	0.05-3.92	0.489
31%-50%	0.14	0.17-1.13	0.065
51%-70%	0.03	0.004-0.30	0.002
> 70%	0.01	0.001-0.16	0.001
Pathological nodal response
0%-10%	Reference
11%-30%	0.474	0.057-3.92	0.489
31%-50%	0.14	0.17-0.13	0.065
51%-70%	0.03	0.004-0.30	0.002
> 70%	0.01	0.001-0.16	0.001
Downstaging
No	Reference
Yes	8	2.34-27.32	0.001

¹Not applicable: only one patient in the chemoradiotherapy group and none in the Chemotherapy group. CI: Confidence interval.