Chemoradiotherapy for poor-risk stage III non-small cell lung cancer.

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Abstract

Cisplatin-based chemoradiotherapy is becoming a standard treatment for patients with stage III non-small cell lung cancer (NSCLC). However, a significant proportion of patients with lung cancer also present with co-morbid conditions that indicate a poor prognosis and poor tolerance of treatment. We have completed a phase I/II study to evaluate the tolerability and efficacy of carboplatin-based chemoradiotherapy for patients with poor-risk stage III NSCLC. Twenty-four patients with stage IIIA/B NSCLC and concurrent medical conditions rendering them ineligible for cisplatin-based chemoradiotherapy protocols were treated with thoracic irradiation, 1.8 to 2 Gy daily to the primary tumor and regional lymph nodes, for a total dose of 61 Gy. Concurrently, patients received carboplatin 200 mg/m2/d intravenously on days 1, 3, 29, and 31, and etoposide 50 mg/m2/d intravenously on days 1 through 4 and 29 through 32. Among 23 assessable patients, 96% completed the two planned courses of chemotherapy and 87% completed the planned chest irradiation. Grade 3/4 toxicities included neutropenia in nine patients (39%), thrombocytopenia in five (22%), esophagitis in seven (30%), and nausea in two (9%). Four patients (17%) achieved a complete response and 16 (70%) a partial response, yielding an overall response rate of 87%. The median survival was 12 months, and the 2- and 3-year survival rates were 30% and 20%, respectively. In conclusion, this treatment regimen was relatively well tolerated, with promising response and survival in patients with poor-risk stage III NSCLC. This pilot study provides a basis for further investigation of this treatment regimen.

Original languageEnglish (US)
JournalSeminars in Oncology
Volume24
Issue number4 Suppl 12
StatePublished - Aug 1997

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Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Carboplatin
Cisplatin
Thorax
Survival
Esophagitis
Etoposide
Therapeutics
Neutropenia
Thrombocytopenia
Nausea
Lung Neoplasms
Survival Rate
Lymph Nodes
Drug Therapy

ASJC Scopus subject areas

  • Oncology

Cite this

Chemoradiotherapy for poor-risk stage III non-small cell lung cancer. / Lau, Derick H; Ryu, J. K.; Gandara, David R.

In: Seminars in Oncology, Vol. 24, No. 4 Suppl 12, 08.1997.

Research output: Contribution to journalArticle

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abstract = "Cisplatin-based chemoradiotherapy is becoming a standard treatment for patients with stage III non-small cell lung cancer (NSCLC). However, a significant proportion of patients with lung cancer also present with co-morbid conditions that indicate a poor prognosis and poor tolerance of treatment. We have completed a phase I/II study to evaluate the tolerability and efficacy of carboplatin-based chemoradiotherapy for patients with poor-risk stage III NSCLC. Twenty-four patients with stage IIIA/B NSCLC and concurrent medical conditions rendering them ineligible for cisplatin-based chemoradiotherapy protocols were treated with thoracic irradiation, 1.8 to 2 Gy daily to the primary tumor and regional lymph nodes, for a total dose of 61 Gy. Concurrently, patients received carboplatin 200 mg/m2/d intravenously on days 1, 3, 29, and 31, and etoposide 50 mg/m2/d intravenously on days 1 through 4 and 29 through 32. Among 23 assessable patients, 96{\%} completed the two planned courses of chemotherapy and 87{\%} completed the planned chest irradiation. Grade 3/4 toxicities included neutropenia in nine patients (39{\%}), thrombocytopenia in five (22{\%}), esophagitis in seven (30{\%}), and nausea in two (9{\%}). Four patients (17{\%}) achieved a complete response and 16 (70{\%}) a partial response, yielding an overall response rate of 87{\%}. The median survival was 12 months, and the 2- and 3-year survival rates were 30{\%} and 20{\%}, respectively. In conclusion, this treatment regimen was relatively well tolerated, with promising response and survival in patients with poor-risk stage III NSCLC. This pilot study provides a basis for further investigation of this treatment regimen.",
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