Safety and efficacy of neoadjuvant cisplatin + S-1 combined with radiation therapy for locally advanced non-small cell lung cancer

Abstract

Purpose: To assess the safety and efficacy of neoadjuvant chemoradiotherapy with cisplatin plus S-1 for advanced non-small cell lung cancer (NSCLC), with a focus on real-world outcomes. Methods: This retrospective study analyzed 32 patients with stage II-III NSCLC eligible for resection, who received preoperative induction therapy between January 2012 and December 2022. Specifically, 20 patients received cisplatin, S-1, and radiation therapy. Results: Among the 32 patients who received induction therapy, the objective response rate (ORR) was 56.2%, and surgical resection was feasible in 29 patients (90.6%). The 5 year recurrence-free survival (RFS) rate was 76.4%, and the 3- and 5 year overall survival (OS) rates were 86.2% and 82.3%, respectively. In the cisplatin + S-1 + radiation therapy group (n = 20), the ORR was 65.0%, and surgical resection was feasible in 17 patients (85.0%). The 3-year RFS and OS rates were 78.3% and 83.8%, respectively. Ef. 3 (complete pathological response) was observed in 3 patients (10.3%). No recurrences occurred in the non-adenocarcinoma subgroup (n = 6), indicating better outcomes relative to the adenocarcinoma group (5-year RFS, 100% vs. 61.4%; p = 0.07). Conclusions: Induction therapy, particularly with cisplatin + S-1 + radiation was associated with promising RFS and OS in locally advanced NSCLC, with favorable tolerability and effectiveness.