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Eur J Cardiothorac Surg 2006;29:896-901
© 2006 Elsevier Science NL

Postoperative complications after induction chemoradiotherapy in patients with non-small-cell lung cancer

^a Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Syogoin Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan
^b Division of Respiratory Medicine, Kobe City General Hospital, 4-6 Minatojima-nakamachi, Chuo-ku, Kobe 650-0046, Japan
^c Division of Thoracic and Cardiovascular Surgery, Kobe City General Hospital, 4-6 Minatojima-nakamachi, Chuo-ku, Kobe 650-0046, Japan
^d Division of Radiology, Kobe City General Hospital, 4-6 Minatojima-nakamachi, Chuo-ku, Kobe 650-0046, Japan

Received 20 January 2006; received in revised form 6 March 2006; accepted 13 March 2006.

^_* Corresponding author. Address: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Syogoin Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan. Tel.: +81 75 751 3830; fax: +81 75 751 4643. (Email: sfujita{at}kuhp.kyoto-u.ac.jp).

Objective: This study evaluates the risks of postoperative complications in 124 patients with non-small-cell lung cancer who received pre-operative induction chemoradiotherapy and surgery. Methods: All patients with non-small-cell lung cancer who underwent surgery after induction therapy between January 1990 and December 2003 were reviewed. We adopted univariate and multiple logistic regression models to identify predictors that increased the incidence of postoperative complications. Results: Of 124 patients, 59 received carboplatin and docetaxel, 53 received cisplatin and etoposide, and 12 received other platinum-based combinations. Pre-operative thoracic radiotherapy was performed concurrently with chemotherapy. The median dose to the primary tumor was 40 Gy, and 29 patients (23.4%) received radiotherapy of more than 45 Gy before surgery. There were 25 pneumonectomies (20.2%). The overall postoperative mortality was 9 of 124 patients (7.3%), and complications developed in 54 patients (43.5%). Multivariate analysis demonstrated that only thoracic radiotherapy of more than 45 Gy predicted postoperative complications (P = 0.021; odds ratio, 3.620; 95% confidence interval, 1.214–10.797). Conclusions: Thoracic radiotherapy of more than 45 Gy, in combination with chemotherapy, was a significant risk factor for postoperative complications.

Key Words: Induction therapy • Non-small-cell lung cancer • Postoperative complications • Radiotherapy • Surgery

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