Compared with radiotherapy concurrent chemoradiotherapy with nedaplatin-based versus cisplatin-based regimen in locally advanced non-small cell lung cancer
10.3760/cma.j.issn.1004-4221.2019.05.003
- VernacularTitle:局部晚期非小细胞肺癌奈达铂和顺铂为主双药同步放化疗结果比较
- Author:
Tao ZHANG
1
;
Nan BI
;
Zongmei ZHOU
;
Dongfu CHEN
;
Zefen XIAO
;
Qinfu FENG
;
Jun LIANG
;
Jima LYU
;
Xin WANG
;
Lei DENG
;
Wenqing WANG
;
Luhua WANG
Author Information
1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科 100021
- Keywords:
Lung neoplasms/concurrent chemoradiotherapy;
Cisplatin;
Nedaplatin;
Treatment outcome
- From:
Chinese Journal of Radiation Oncology
2019;28(5):334-338
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy and toxicity between nedaplatin-and cisplatin-based regimens in patients with unresectable locally advanced non-small cell lung cancer (NSCLC) receiving concurrent chemoradiotherapy.Methods From January,2015 to December,2016,patients with unresectable locally advanced NSCLC receiving concurrent chemoradiotherapy were included in this study.Patients received thoracic radiotherapy (RT) combined with nedaplatin-based concurrent chemotherapy were enrolled in the nedaplatin group (n=38).Those treated with thoracic RT combined with cisplatin-based chemotherapy were allocated into the cisplatin group (n=84).The chemotherapy regime consisted of platinumin combination with paclitaxel or etoposide.Platinum combined with pemetrexed was adopted in patients with adenocarcinoma.Overall,the median age was 58 years old.Most of the patients were male (86.1％),77.0％ of them had a history of smoking and 63.9％ of the patients were pathologically diagnosed with squamous cell carcinoma.Besides,59.0％ of the patients had Ⅲ B NSCLC.Results In the nedaplatin and cisplatin groups,the overall response rate (ORR) was 79％ and 86％,and the disease control rate was 94％ and 94％.The median follow-up time was 20 months.In the nedaplatin group,the 1-and 2-year PFS was 49％ and 23％,and 67％ and 39％ in the cisplatin group (P=0.160).In the nedaplatin group,the 1-and 2-year OS was 91％ and 72％,and 89％ and 68％ in the cisplatin group (P=0.552).Nine patients (24％) had ≥grade 3 adverse events in the nedaplatin group and 25 patients (30％) in the cisplatin group (P=0.488).No statistical significance was found in radiation-induced esophagitis,bone marrow suppression and gastrointestinal toxicity between two groups.One patient in the nedaplatin group presented with grade 3 radiation-induced pneumonitis and 2 patients died of radiation-induced pneumonitis in the cisplatin group.Conclusions Thoracic radiotherapy combined with nedaplatin-based chemotherapy is a promising option for patients with unresectable locally NSCLC.Compared with the cisplatin-based chemotherapy,nedaplatin-based regime yields equivalent clinical efficacy and less adverse events,especially suitable for the elderly patients with poor tolerance.
