Adjuvant chemotherapy after complete resection of non-small cell lung cancer

Introduction: In non-small cell lung cancer (NSCLC) surgical resection is the treatment of choice in stages I and II of the disease; but even of this selected group of patients, almost half suffer recurrence following complete resection, usually in the form of distant metastases. The role of adjuvant systemic chemotherapy has been investigated extensively in the last two decades.

Methods: Selective literature review of randomized phase III trials.

Results and discussion: There is currently no indication for adjuvant chemotherapy in patients with stage IA disease, whereas the role of adjuvant chemotherapy for stage IB disease remains controversial. To treat a patient with stage IB disease should be an individualized decision depending on age, tumor size, vascular invasion, and patient preference. Adjuvant chemotherapy is now the standard of care after complete resection of stage II-IIIA NSCLC. Patients considered for adjuvant chemotherapy should be under 75 years of age, have no contraindications to cisplatin-based chemotherapy, and should be in a good performance status after surgery. Currently the standard adjuvant chemotherapy regimen is a combination containing cisplatin and vinorelbine.