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Ann Thorac Surg 2002;74:1008-1010
© 2002 The Society of Thoracic Surgeons

Original article: general thoracic

Induction chemotherapy before operation for multiple endobronchial squamous cell carcinoma of the lung

Kotaro Kameyama, MDa, Cheng-long Huang, MDa, Eiichi Hayashi, MDa, Dage Liu, MDa, Taku Okamoto, MDa, Yasumichi Yamamoto, MDa, Hiroyasu Yokomise, MDa*

a Second Department of Surgery, Kagawa Medical University, Kagawa, Japan

Accepted for publication June 13, 2002.

* Address reprint requests to Dr Yokomise, Kagawa Medical University, 1750-1, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
e-mail: yokomise{at}kms.ac.jp

BACKGROUND: Multiple endobronchial squamous cell carcinoma is sometimes difficult to resect due to poor pulmonary function. Although various therapeutic modalities are available, there is no consensus on the effectiveness of chemotherapy in such rare cases. In this study, we evaluated the efficacy of preoperative induction chemotherapy for patients with otherwise unresectable multiple endobronchial squamous cell carcinoma and poor pulmonary function.

METHODS: Six patients with multiple endobronchial squamous cell carcinoma were enrolled in the study. They had a total of 15 foci that were in clinical stage I or II. Due to severe emphysema and poor pulmonary function, all 6 patients were considered unsuitable for complete surgical excision if either bilateral thoracotomy or pneumonectomy was required. The patients received two courses (at 3- to 4-week intervals) of induction chemotherapy, beginning on day 1 with cisplatin (80 mg/m2), vindesine (3 mg/m2), and mitomycin-C (8 mg/m2). After induction chemotherapy, surgical resection was performed on all 6 patients as bilateral thoracotomy and pneumonectomy were avoided due to the effectiveness of induction chemotherapy.

RESULTS: Postoperative pathologic examination revealed a complete response in eight foci. Four nonresected foci have not recurred so far. Although three residual tumors were observed in resected specimens, they all showed moderate responses to chemotherapy. The possible complete response rate is 80%. All patients have survived for 2 to 10 years without apparent recurrence.

CONCLUSIONS: Induction chemotherapy can be added to treatment options for patients with rare multiple endobronchial squamous carcinoma that cannot be resected because of poor pulmonary function.




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