J Korean Cancer Assoc.  1997 Oct;29(5):807-815.

The Effect of Neoadjuvant Chemotherapy with 5-Fluorouracil (5-FU), Vinblastine and Cisplatin (FVP) for Stage III Non-Small Cell Lung Cancer (NSCLC)

• Won JI
• Chun JH
• Kim HJ
• Jo MS
• Kim DK
• Kwak YT
• Kim JS
• Choi SJ
• Kim SR

Abstract

PURPOSE: As the prognosis of stage III NSCLC is still poor with or without operation, we conducted a phase II trial of neoadjuvant chemotherapy (CHT) with 5-FU, vinblastine, cisplatin prior to surgery to determine the effect on resectability and survival. MATERIALS AND METHOD: Patients (pt) received 5-FU 500mg/m2/12 hours continuous infusion for 36 hours, vinblastine 3mg/m2/day iv bolus day 1 and day 2, and cisplatin 75mg/m2 iv day 1 every 3 weeks. This regimen was given for 2 cycles. When the tumor was responsive (stable disease or better), 1 or 2 more cycles of the CHT were given, followed by operation when totally resectable on chest CT/MRI, then 3 more cycles of the CHT to finish the treatment; when the tumor was neither responsive nor resectable after 3rd or 4th CHT, radiotherapy was started. RESULT: Twenty nine pt were enrolled and 26 pt have been evaluable so far. Age ranged from 32 to 79 (median 59 years); 23 were male, 3 female. Total of 108 cycles were given (mean 4.2). There were 4 partial remissions out of 6 IIIAs (67%) and 10 out of 20 IIIBs (50%), with overall response rate of 53.8%; down staging was noted in 9 patients (34.6%). 9 pt (34.6%) underwent curative resection successfully; 4 out of 6 IIIAs (67%) and 5 out of 20 IIIBs (25.0%); 1 patient refused operation. Median survival was 31.3 months for 9 pt with operation, and that of all patients was 14.2 months. Radiation was given to 9 pt, resulting in 3 partial remissions (PR), 3 stable diseases (SD), 3 progressive diseases (PD). Serious (WHO grade> or =3) toxicities were nausea/emesis in 2.8%, granulocytopenia in 26.9% and thrombocytopenia in 2.8%.
CONCLUSION
This treatment modality seemed to be effective, encouraging further phase III study for better determination of its role.

Keyword

5-Fluorouracil; Vinblastine; Cisplatin; Neoadjuvant chemotherapy; Non-small cell lung cancer

MeSH Terms

Agranulocytosis
Carcinoma, Non-Small-Cell Lung*
Cisplatin*
Drug Therapy*
Female
Fluorouracil*
Humans
Male
Prognosis
Radiotherapy
Thorax
Thrombocytopenia
Vinblastine*
Cisplatin
Fluorouracil
Vinblastine