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For patients with NSCLC undergoing surgical resection with curative intent, clinical trials have demonstrated that adjuvant cisplatin-based chemotherapy prolongs life and improves other outcomes, notes Benjamin P. Levy, MD. Chemotherapy may be administered after surgery (adjuvant chemotherapy) or before surgery (neoadjuvant chemotherapy).
The results of meta-analyses have demonstrated that outcomes with neoadjuvant chemotherapy are similar to outcomes with adjuvant chemotherapy. There are theoretical benefits associated with a neoadjuvant approach, comments Levy. For example, with a neoadjuvant approach, patients may be more likely to complete all 4 planned cycles of chemotherapy, whereas it may be more challenging for patients to complete all 4 cycles of chemotherapy after surgery. Levy adds that at his practice site, clinicians generally rely on adjuvant chemotherapy.