Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2021; 12(11): 1047-1063
Published online Nov 24, 2021. doi: 10.5306/wjco.v12.i11.1047
Pathological response to neoadjuvant therapy with chemotherapy vs chemoradiotherapy in stage III NSCLC-contribution of IASLC recommendations
Diego Muñoz-Guglielmetti, David Sanchez-Lorente, Roxana Reyes, Daniel Martinez, Carmen Lucena, Marc Boada, Pilar Paredes, Marta Parera-Roig, Ivan Vollmer, Joel Mases, Roberto Martin-Deleon, Sergi Castillo, Mariana Benegas, Silvia Muñoz, Maria Mayoral, Carla Cases, Meritxell Mollà, Francesc Casas
Diego Muñoz-Guglielmetti, Joel Mases, Carla Cases, Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
David Sanchez-Lorente, Marc Boada, Thoracic Surgery Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Roxana Reyes, Medical Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Daniel Martinez, Pathology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Carmen Lucena, Pneumology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Pilar Paredes, Nuclear Medicine Department, Faculty of Medicine of University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona 08036, Cataluña, Spain
Marta Parera-Roig, Medical Oncology Department, Hospital Comarcal de Vic, Vic 08500, Cataluña, Spain
Ivan Vollmer, Mariana Benegas, Radiology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Roberto Martin-Deleon, Pneumology Department, Hospital Universitario Reina Sofia, Córdoba 14004, Andalucía, Spain
Sergi Castillo, Medical Oncology Department, Hospital de Mollet, Mollet 08100, Cataluña, Spain
Silvia Muñoz, Medical Oncology Department, Hospital General de Granollers, Granollers 08402, Cataluña, Spain
Maria Mayoral, Nuclear Medicine Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Meritxell Mollà, Francesc Casas, Radiation Oncology Department, Thoracic Unit, Hospital Clínic de Barcelona, Barcelona 08036, Cataluña, Spain
Author contributions: Muñoz Guglielmetti D, Sanchez-Lorente D, Reyes R, Martinez D, Lucena C, Boada M, Paredes P, Parera-Roig M, Vollmer I, Mases J, Martin-Deleon R, Castillo S, Benegas M, Muñoz S, Mayoral M, Cases C, Mollà M and Casas F collaborated in the preparation of this manuscript; Statistical analyses and the final review were performed by Muñoz Guglielmetti D.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Hospital Clínic de Barcelona.
Conflict-of-interest statement: We have no conflict of interest or financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Diego Muñoz-Guglielmetti, MD, Doctor, Radiation Oncology, Hospital Clínic de Barcelona, Carrer de Villarroel 170, Barcelona 08036, Cataluña, Spain. dimunoz@clinic.cat
Received: March 26, 2021
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

Longer follow-up of these patients is necessary to establish a relationship between pathological response and clinical outcomes.