# Induction chemoradiation in stage IIIA/N2 non-small-cell lung cancer: a phase 3 randomised trial (SAKK 16/00)

Source: https://onco.cc/key-papers/paper-pless-sakk-16-00-induction-chemoradiation-lancet-2015/  
OnCo record `paper-pless-sakk-16-00-induction-chemoradiation-lancet-2015` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The Swiss trial group's randomised test of adding radiotherapy before lung cancer surgery: it added side effects and no benefit, so chemotherapy and one local treatment are enough.

## Summary

The report of SAKK 16/00, led from Kantonsspital Winterthur with investigators at CHUV Lausanne, University Hospital Zurich and other centres. Patients with resectable stage IIIA/N2 non-small-cell lung cancer received three cycles of cisplatin and docetaxel and were randomised to 44 Gy of radiotherapy before surgery or to surgery directly. Event-free survival did not differ, and 91 per cent of patients completed the three chemotherapy cycles.

## Fields

- Kind: Key paper
- Last checked: 2026-11-03
- Journal: The Lancet
- Year: 2015
- DOI: 10.1016/S0140-6736(15)60294-X
- Authors: Pless M, Stupp R, Ris HB, Stahel RA, Weder W, et al.
- Findings: 232 patients were randomised at 23 centres in Switzerland, Germany and Serbia from 2001 to 2012: 117 to chemoradiotherapy and 115 to chemotherapy alone before surgery.; Median event-free survival was 12.8 months (95 per cent CI 9.7 to 22.9) with radiotherapy and 11.6 months (8.4 to 15.2) without, p=0.67.; Median overall survival was 37.1 months (22.6 to 50.0) with radiotherapy and 26.2 months (19.9 to 52.1) without.; Grade 3 dysphagia from radiotherapy occurred in seven patients (7 per cent); three patients in the control group died within 30 days of surgery.
- What it means: For resectable stage IIIA/N2 disease, induction chemotherapy followed by a single definitive local treatment, surgery or radiotherapy, is adequate; stacking radiotherapy before surgery adds toxicity without improving event-free survival.
- Caveats: The trial predates immunotherapy before and after surgery, which has since changed treatment of resectable stage III disease.; Overall survival was a secondary endpoint and its confidence intervals overlap widely.

## Sources

- Lancet 2015: https://doi.org/10.1016/S0140-6736(15)60294-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/26275735/

## Connected records

- cancers: [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Radiation Therapy](https://onco.cc/fronts/radiation/)
- companies: [Swiss Cancer Institute (formerly SAKK)](https://onco.cc/companies/swiss-cancer-institute/)
- institutions: [Lausanne University Hospital (CHUV) / Ludwig Institute Lausanne](https://onco.cc/institutions/chuv-lausanne/), [Swiss Cancer League (Krebsliga Schweiz)](https://onco.cc/institutions/swiss-cancer-league/), [University Hospital Zurich / Comprehensive Cancer Center Zurich](https://onco.cc/institutions/usz-zurich/)
- trials: [SAKK 16/00](https://onco.cc/trials/sakk-16-00/)
- people: [Roger Stupp](https://onco.cc/people/roger-stupp/), [Rolf A. Stahel](https://onco.cc/people/rolf-stahel/)

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