Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer: A Southwest oncology group phase II study, SWOG 9019

Kathy S. Albain, John J. Crowley, Andrew T. Turrisi, David R Gandara, William B. Farrar, Joseph I. Clark, Kristie R. Beasley, Robert B. Livingston

Research output: Contribution to journalArticle

255 Citations (Scopus)

Abstract

Purpose: There are no published survival data after chemoradiotherapy (chemoRT) in pathologically documented stage IIIB non-small-cell lung cancer. Studies of radiotherapy (RT) alone or chemotherapy followed by RT yield 5-year survivals less than 10%. The Southwest Oncology Group (SWOG) employed the same concurrent chemoRT induction regimen used in its predecessor trimodality trial to determine the efficacy, safety, and long-term outcome of replacing postinduction surgery with additional chemoRT. Patients and Methods: Eligible patients for SWOG-9019 had pathologic documentation of T4N0/1, T4N2, or N3 stage IIIB non-small-cell lung cancer. They had pulmonary function adequate to withstand combined-modality therapy, identical to the requirements of the previous trial with postchemoRT surgery. Induction therapy was two cycles of cisplatin plus etoposide (PE) concurrent with once-daily thoracic RT (45 Gy). In the absence of progressive disease, RT was completed to 61 Gy, with two additional cycles of cisplatin plus etoposide. Results: Fifty eligible patients were accrued with tumor-node (TN) substage confirmed on central review: 18, T4N0/1; 12, T4N2; and 20, N3. Grade 4 neutropenia was the most common toxicity (32%). Grade 3/4 esophagitis occurred in 12% and 8%. Median follow-up was 52 months, and overall median survival was 15 months (10 to 22, 95% confidence interval). Three- and 5-year survivals were 17% and 15% (5-year T4N0/1, 17%; T4N2, 13%; and N3, 15%). Conclusion: Feasibility and long-term survival support the application of these results as a standard against which mature outcomes of chemoRT trials with new chemotherapy agents can be compared. These results also justify use of the SWOG-9019 approach as a control arm in ongoing phase III trials.

Original languageEnglish (US)
Pages (from-to)3454-3460
Number of pages7
JournalJournal of Clinical Oncology
Volume20
Issue number16
DOIs
StatePublished - Aug 15 2002

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Etoposide
Non-Small Cell Lung Carcinoma
Cisplatin
Chemoradiotherapy
Radiotherapy
Thorax
Survival
Drug Therapy
Combined Modality Therapy
Esophagitis
Neutropenia
Documentation
Confidence Intervals
Safety
Lung
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer : A Southwest oncology group phase II study, SWOG 9019. / Albain, Kathy S.; Crowley, John J.; Turrisi, Andrew T.; Gandara, David R; Farrar, William B.; Clark, Joseph I.; Beasley, Kristie R.; Livingston, Robert B.

In: Journal of Clinical Oncology, Vol. 20, No. 16, 15.08.2002, p. 3454-3460.

Research output: Contribution to journalArticle

Albain, Kathy S. ; Crowley, John J. ; Turrisi, Andrew T. ; Gandara, David R ; Farrar, William B. ; Clark, Joseph I. ; Beasley, Kristie R. ; Livingston, Robert B. / Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer : A Southwest oncology group phase II study, SWOG 9019. In: Journal of Clinical Oncology. 2002 ; Vol. 20, No. 16. pp. 3454-3460.
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abstract = "Purpose: There are no published survival data after chemoradiotherapy (chemoRT) in pathologically documented stage IIIB non-small-cell lung cancer. Studies of radiotherapy (RT) alone or chemotherapy followed by RT yield 5-year survivals less than 10{\%}. The Southwest Oncology Group (SWOG) employed the same concurrent chemoRT induction regimen used in its predecessor trimodality trial to determine the efficacy, safety, and long-term outcome of replacing postinduction surgery with additional chemoRT. Patients and Methods: Eligible patients for SWOG-9019 had pathologic documentation of T4N0/1, T4N2, or N3 stage IIIB non-small-cell lung cancer. They had pulmonary function adequate to withstand combined-modality therapy, identical to the requirements of the previous trial with postchemoRT surgery. Induction therapy was two cycles of cisplatin plus etoposide (PE) concurrent with once-daily thoracic RT (45 Gy). In the absence of progressive disease, RT was completed to 61 Gy, with two additional cycles of cisplatin plus etoposide. Results: Fifty eligible patients were accrued with tumor-node (TN) substage confirmed on central review: 18, T4N0/1; 12, T4N2; and 20, N3. Grade 4 neutropenia was the most common toxicity (32{\%}). Grade 3/4 esophagitis occurred in 12{\%} and 8{\%}. Median follow-up was 52 months, and overall median survival was 15 months (10 to 22, 95{\%} confidence interval). Three- and 5-year survivals were 17{\%} and 15{\%} (5-year T4N0/1, 17{\%}; T4N2, 13{\%}; and N3, 15{\%}). Conclusion: Feasibility and long-term survival support the application of these results as a standard against which mature outcomes of chemoRT trials with new chemotherapy agents can be compared. These results also justify use of the SWOG-9019 approach as a control arm in ongoing phase III trials.",
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T1 - Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer

T2 - A Southwest oncology group phase II study, SWOG 9019

AU - Albain, Kathy S.

AU - Crowley, John J.

AU - Turrisi, Andrew T.

AU - Gandara, David R

AU - Farrar, William B.

AU - Clark, Joseph I.

AU - Beasley, Kristie R.

AU - Livingston, Robert B.

PY - 2002/8/15

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N2 - Purpose: There are no published survival data after chemoradiotherapy (chemoRT) in pathologically documented stage IIIB non-small-cell lung cancer. Studies of radiotherapy (RT) alone or chemotherapy followed by RT yield 5-year survivals less than 10%. The Southwest Oncology Group (SWOG) employed the same concurrent chemoRT induction regimen used in its predecessor trimodality trial to determine the efficacy, safety, and long-term outcome of replacing postinduction surgery with additional chemoRT. Patients and Methods: Eligible patients for SWOG-9019 had pathologic documentation of T4N0/1, T4N2, or N3 stage IIIB non-small-cell lung cancer. They had pulmonary function adequate to withstand combined-modality therapy, identical to the requirements of the previous trial with postchemoRT surgery. Induction therapy was two cycles of cisplatin plus etoposide (PE) concurrent with once-daily thoracic RT (45 Gy). In the absence of progressive disease, RT was completed to 61 Gy, with two additional cycles of cisplatin plus etoposide. Results: Fifty eligible patients were accrued with tumor-node (TN) substage confirmed on central review: 18, T4N0/1; 12, T4N2; and 20, N3. Grade 4 neutropenia was the most common toxicity (32%). Grade 3/4 esophagitis occurred in 12% and 8%. Median follow-up was 52 months, and overall median survival was 15 months (10 to 22, 95% confidence interval). Three- and 5-year survivals were 17% and 15% (5-year T4N0/1, 17%; T4N2, 13%; and N3, 15%). Conclusion: Feasibility and long-term survival support the application of these results as a standard against which mature outcomes of chemoRT trials with new chemotherapy agents can be compared. These results also justify use of the SWOG-9019 approach as a control arm in ongoing phase III trials.

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