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Study: Chemo after surgery aids lung cancer patients

By Associated Press
© St. Petersburg Times
published June 3, 2003

CHICAGO - A large international study has shown for the first time that offering chemotherapy after surgery can modestly improve the survival of people with early-stage lung cancer.

Even though the benefit is small, doctors say the discovery is important, both because lung cancer is such a grim diagnosis and because it is so common. It is the No. 1 cancer killer, diagnosed in 1.2-million people around the world each year, and 85 percent of victims die of the disease.

Chemotherapy after surgery is standard for treatment of breast and colon cancer. But until now, there has been no convincing evidence that it changes the course of lung cancer. Doctors do offer chemotherapy to patients, but the treatment is typically intended to ease symptoms rather than delay death.

The latest study, released Monday, suggests lung cancer patients do have another treatment option, if their tumors are found early and can be removed with surgery. A followup round of chemotherapy improves their survival by several months.

Dr. Thierry Le Chevalier, who directed the study, said the results mean chemotherapy should be a routine option for patients who have surgery for early lung cancer.

"The benefit reported could prevent annually around 7,000 deaths worldwide," he said at a meeting in Chicago of the American Society of Clinical Oncology (

Several doctors agreed that the results will have a major impact, although some questioned whether the change will be immediately embraced by all specialists.

"This will change the way lung cancer is treated," predicted the society's president, Dr. Paul Bunn, a lung cancer specialist at the University of Colorado.

However, Dr. Nassar Hanna of Indiana University noted that several smaller studies have tried and failed to prove that chemotherapy does any good after lung cancer surgery.

"I don't think there will be an across-the-board change in practice, although many will be swayed," Hanna said.

Doctors enrolled 1,867 patients at 148 hospitals in 33 countries. They were randomly assigned to get an operation alone or surgery plus chemotherapy. The treatment regimens included the drug cisplatin plus a variety of other standard chemotherapy medicines.

After five years, 45 percent of patients getting chemotherapy were still alive, compared with 40 percent of those getting only surgery. Average survival was 51 months for the chemotherapy patients and 44 months for the comparison group.

Cisplatin can carry serious side effects, including a drop in white blood cells that leaves patients open to infection.

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