Adjuvant chemotherapy for completely resected non-small cell lung cancer: a systematic review

Crit Rev Oncol Hematol. 2006 May;58(2):146-55. doi: 10.1016/j.critrevonc.2005.10.002. Epub 2006 Jan 18.


Purpose: To conduct a systematic review and to evaluate the impact of postoperative adjuvant chemotherapy on the survival of patients with completely resected non-small cell lung cancer.

Methods: Relevant randomized trials and meta-analyses, published as articles or abstracts, were identified through electronic and hand searches by two reviewers.

Results: Seven meta-analyses and 26 randomized trials comparing surgery with or without chemotherapy met the pre-defined eligibility criteria for the review. The meta-analyses all showed a survival advantage for platinum- or UFT-based postoperative chemotherapy, although the results did not always achieve statistical significance. The results of individual trials were inconsistent, although recent trials have detected a large survival advantage with postoperative platinum-based chemotherapy. Differences in trial design, patient characteristics, disease stage, use of radiotherapy and chemotherapy regimen may explain the variation in results.

Conclusions: Postoperative adjuvant platinum-based chemotherapy improves survival compared with surgery alone in completely resected non-small cell lung cancer. In patients fit for chemotherapy, the survival benefits strongly outweigh the adverse effects of the treatment.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Carboplatin / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Chemotherapy, Adjuvant
  • Cisplatin / therapeutic use
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Neoplasm Invasiveness
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic


  • Antineoplastic Agents
  • Carboplatin
  • Cisplatin