Chemo-radiotherapy for stage III unresectable non-small cell lung cancer—long-term results of a prospective study

Introduction: Combined-modality treatment is considered standard of care in the treatment of stage III non-small-cell lung cancer (NSCLC). This study was designed to assess the efficacy and tolerability of induction paclitaxel/carboplatin followed by concurrent thoracic radiotherapy and weekly pacli...

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Published in:Respiratory medicine 2004-11, Vol.98 (11), p.1080-1086
Main Authors: Leong, Swan Swan, Fong, Kam Weng, Ong, Yew Kwang, Foo, Kian Fong, Ang, Peter, Wee, Joseph, Lee, Khai Mun, Tan, Eng Huat
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Cancer therapies
Carboplatin - administration & dosage
Carboplatin - adverse effects
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - radiotherapy
Chemotherapy
Clinical trials
Combined Modality Therapy
Combined-modality
Disease control
Disease-Free Survival
Esophagitis
Esophagitis - etiology
Esophagus
Family medical history
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hematologic and hematopoietic diseases
Hematologic Diseases - etiology
Humans
Locally advanced
Lung cancer
Lung Neoplasms - drug therapy
Lung Neoplasms - radiotherapy
Male
Medical imaging
Medical sciences
Middle Aged
Mortality
Neurotoxicity
Neutropenia
Other diseases. Hematologic involvement in other diseases
Other diseases. Semiology
Paclitaxel - administration & dosage
Paclitaxel - adverse effects
Pneumology
Prospective Studies
Radiation therapy
Survival Rate
Tomography
Treatment Outcome
Tumors of the respiratory system and mediastinum
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Summary:Introduction: Combined-modality treatment is considered standard of care in the treatment of stage III non-small-cell lung cancer (NSCLC). This study was designed to assess the efficacy and tolerability of induction paclitaxel/carboplatin followed by concurrent thoracic radiotherapy and weekly paclitaxel. Materials and methods: Patients with unresectable stage III NSCLC were treated prospectively with two cycles of paclitaxel (175 mg/m 2) and carboplatin (area under the curve of 6) followed by radiotherapy (60–66 Gy) concurrent with 6 weekly doses of paclitaxel (60 mg/m 2). Response was determined 8 weeks after the completion of treatment and treatment-related toxicities were assessed at each visit during treatment and follow-up. Results: Sixty-three patients were treated, 5 had complete response and 33 had partial response, giving a response rate of 60%. Thirty-seven percent of patients developed grade 3 or 4 neutropenia; 48% had significant esophagitis requiring the use of narcotic analgesics. Two patients developed esophageal stricture subsequently. The median survival was 51 months and 12 months for stage IIIA and IIIB patients, respectively. Progression-free survival was 16months and 11months respectively. Conclusions: The response rate was encouraging. Esophagitis was a significant morbidity and should prompt modification of treatment regimen, either in the chemotherapy schedule or by adjusting the radiotherapy treatment planning.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2004.03.020