Regional plus systemic chemotherapy: an effective treatment in recurrent non-small cell lung cancer

Aims This study was undertaken to determine the activity and toxicity of regional chemotherapy using an isolated thoracic perfusion (ITP) technique as second-line treatment for patients with advanced and recurrent non-small cell lung cancer (NSCLC). Methods Eighteen patients with relapsed NSCLC confined to the thoracic region entered the study and received regional chemotherapy using ITP plus low-dose systemic chemotherapy. All 18 patients had been pre-treated with some form of chemotherapy, surgery and/or radiotherapy. The cytostatic regimen had two components: (1) ITP using mitomycin 10 mg/m2, navelbine 25 mg/m2and cisplatin 30 mg/m2on day 1; (2) systemic chemotherapy with 5-fluorouracil 250 mg/m2and cisplatin 20 mg/m2given as a continuous infusion over 24 h on days 1–4. Results All 18 patients were assessable for toxicity, tumour response and survival. There were 10/18 responses (CR 0; PR 10): a response rate of 56%. Side-effects were transient and acceptable. No treatment-related death occurred. Median survival was 21 months and the 1-year survival rate was 75%. Conclusion Regional chemotherapy using ITP plus low-dose systemic chemotherapy is effective in recurrent advanced NSCLC, with an encouraging survival outcome.