Induction Chemotherapy Followed by Concurrent Chemoradiotherapy in Patients with Unresectable Stage III Nonsmall Cell Lung Cancer.
- Author:
Hee Chul PARK
1
;
Su Ssan KIM
;
Hoonsik BAE
;
Hyo Jung KIM
;
Dae Young ZANG
;
Young Iee PARK
;
Dong Kyu KIM
;
Ki Suck JUNG
;
Jin Seok AHN
Author Information
1. Department of Radiation Oncology, Hallym University College of Medicine, Chuncheon, Korea.
- Publication Type:Original Article
- Keywords:
Non-small cell lung cancer;
Induction chemotherapy;
Concurrent chemo-radiotherapy;
Paclitaxel;
Cisplatin
- MeSH:
Carcinoma, Non-Small-Cell Lung*;
Chemoradiotherapy*;
Cisplatin;
Disease-Free Survival;
Disulfiram;
Esophagitis;
Follow-Up Studies;
Humans;
Induction Chemotherapy*;
Lung Abscess;
Paclitaxel;
Radiation Pneumonitis;
Radiotherapy;
Survival Rate;
Tomography, X-Ray Computed
- From:Journal of Lung Cancer
2005;4(1):27-33
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE : We conducted a phase II trial of the addition of a paclitaxel and cisplatin regimen as induction chemotherapy to concurrent thoracic radiation therapy and weekly paclitaxel and cisplatin in locally advanced unresectable stage III non-small cell lung cancer. The endpoints were to determine the applicability, safety, response rate and survival statistics. MATERIALS AND METHODS : The induction chemotherapy consisted of paclitaxel 175 mg/m2 given 3 hours on day 1 and cisplatin 75 mg/m2 given over 1 hour on day 2 repeated 3 weeks for two cycles. Thoracic radiation therapy 63 Gy/35 fractions in daily 1.8 Gy fractions along with paclitaxel 45 mg/m2/1 hr and cisplatin 20 mg/m2/1 hr given 2~4 hours before irradiation repeated every week for 6 cycles. To minimize the toxicities of a concurrent portion of treatment, the treatment planning for thoracic radiation therapy was done throughly with the assistance of a planning CT scans and computerized radiation treatment planning system. RESULTS : Twenty-nine patients were enrolled between Sep 1999 to Sep 2002. The overall response rate after the induction chemotherapy was 79.3%. Due to the refusal of further treatment, 1 patient left the trial. Twenty-three (79.3%) of the 29 patients received the concurrent portion of treatment. Five (17.2%) patients received the radiation therapy alone, two due to refusal, two for decreased performance stati, one due to pulmonary abscess. After completion of the entire course of treatment, 5 (17.2%) patients gained the complete remission and the overall response rate of 79.3%. With a median follow-up of 22 months, the 1-, 2- and 3-year overall survival rates were 75.7, 53.4 and 41.6%. The progression free survival rates were 52.5 and 20.5% at 1- and 2-year, respectively. Induction chemotherapy was well tolerated. Among 23 patients who completed the entire course of treatment including the concurrent portion, 6 (34.8%) suffered hematologic toxicities more than grade 3, 2 (8.7%) had esophagitis greater than grade 3 and 3 (13.3%) had radiation pneumonitis greater than grade 3. CONCLUSION : We concluded that weekly Paclitaxel+ Cisplatin with concurrent radiotherapy following 2 cycles of induction chemotherapy with Paclitaxel+Cisplatin repeated 3 weeks is effective and welltolerated, should be further evaluated in a randomized phase III trial
