Trials comparing surgery (± other treatment) with non-surgical treatment arm
| Study (year) | Subjects | Intervention | Control | Number randomised | Outcomes |
|---|---|---|---|---|---|
| *Includes some cases of small cell lung cancer. | |||||
| †ECOG, Eastern Cooperative Oncology Group performance status (0 = asymptomatic, 1 = capable of light work, 2 = less then half daylight hours in bed). | |||||
| ‡Trial closed prematurely. | |||||
| §RTOG, Radiation Therapy Oncology Group. | |||||
| MRC, UK (1954–8)25 | Histologically confirmed, clinically locoregional lung cancer* | Thoracotomy and radical resection of tumour with hilar and mediastinal nodes | Radiotherapy (45 Gy to primary and mediastinum) | 58 | Overall 4 year survival |
| NCI, USA (1963–6)27 | Histologically confirmed inoperable locally advanced lung cancer,* potentially operable after radiotherapy | Radiotherapy (40 Gy to primary and mediastinum) followed by surgery | Radiotherapy only (40 Gy to primary and mediastinum) | 425 inoperable patients given radiotherapy,152 randomised | Overall and disease free 5 year survival |
| National Cancer Institute of Canada Clinical Trials Group (before 1997)26‡ | Stage IIIA NSCLC (pN2) fit for surgery, ECOG ⩽2† | Induction chemotherapy followed by surgical resection | Radiotherapy (60 Gy total, 50 Gy to primary tumour and mediastinum, plus 10 Gy to reduced target volume) | 31 | Overall 2 year survival |
| RTOG§ 89–01 trial, USA (1990–4)17‡ | T1–T3 pN2M0 NSCLC | Induction cisplatin based chemotherapy followed by surgical resection | Induction cisplatin based chemotherapy followed by radiotherapy (64 Gy) | 73 given induction chemotherapy, 61 randomised | Overall 4 year survival |
| University of Athens, Greece, (1998–91)16‡ | Stage IIIA NSCLC (exact TNM not stated) Karnofsky performance status 70–90 | 4 cycles cisplatin based chemotherapy followed by surgical resection | 6 cycles of cisplatin based chemotherapy followed by radiotherapy (50 Gy) | 40 | Overall 5 year survival |
| North American Intergroup trial 0139 (RTOG 93–09),(1994–2001)20 | T1–3 pN2M0 NSCLC, surgical resection technically feasible at randomisation | Concurrent cisplatin and etoposide and radiotherapy(45 Gy) followed by surgical resection | Concurrent cisplatin and etoposide and radiotherapy (61 Gy) | 429 | Progression free and overall 3 year survival |