Rapidly alternating radiotherapy and high dose cisplatin chemotherapy in stage IIIB non-small cell lung cancer

Results of a phase I/II study

David R Gandara, Frank H. Valone, Edith A. Perez, Albert B. Deisseroth, Mack Roach, David K. Ahn, Theodore Phillips

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Alternating radiotherapy and chemotherapy increases tumor cure rates in some animal models with reduced normal tissue damage compared to sequential use of these modalities. To test this concept in non-small cell lung cancer, 23 patients with predominantly Stage IIIB disease were treated on a Northern California Oncology Group pilot study of alternating radiotherapy and high dose cisplatin. Radiotherapy consisted of 6000 cGy delivered in three separate 10-day courses of 200 cGy/fraction/day during weeks 1 and 2, 5 and 6, and 9 and 10. High dose cisplatin, 100 mg/m2 in 3% saline, was administered on weeks 3 and 4, 7 and 8, 11 and 12, and 15 and 16. The response rate in 22 eligible patients is 73% ( 16 22) with four complete responses and 12 partial responses. Feasibility of this approach is demonstrated by 20 22 patients completing radiotherapy and a median of 2.5 courses of chemotherapy administered. Median survival time is 14.2 months (range 2-40+ months). One- and 2-year survival rates are 64% ( 14 22) and 41% ( 9 22), respectively. Hematologic, renal, and radiation-related toxicities were significant but manageable. We conclude that rapid alternation of radiotherapy and a high dose intensity cisplatin regimen is feasible in Stage IIIB non-small cell lung cancer, with a high response rate and acceptable toxicity. The long-term impact on local control and survival remains unclear, although preliminary survival data are encouraging in this poor prognosis population. Further studies of this concept are warranted.

Original languageEnglish (US)
Pages (from-to)1047-1052
Number of pages6
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume20
Issue number5
DOIs
StatePublished - May 1 1991

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chemotherapy
Non-Small Cell Lung Carcinoma
lungs
Cisplatin
radiation therapy
Radiotherapy
cancer
Drug Therapy
dosage
toxicity
Survival
animal models
prognosis
alternations
tumors
Survival Rate
Animal Models
Radiation
damage
Kidney

Keywords

  • Alternating radiotherapy
  • Cisplatin
  • Non-small cell lung cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Rapidly alternating radiotherapy and high dose cisplatin chemotherapy in stage IIIB non-small cell lung cancer : Results of a phase I/II study. / Gandara, David R; Valone, Frank H.; Perez, Edith A.; Deisseroth, Albert B.; Roach, Mack; Ahn, David K.; Phillips, Theodore.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 20, No. 5, 01.05.1991, p. 1047-1052.

Research output: Contribution to journalArticle

Gandara, David R ; Valone, Frank H. ; Perez, Edith A. ; Deisseroth, Albert B. ; Roach, Mack ; Ahn, David K. ; Phillips, Theodore. / Rapidly alternating radiotherapy and high dose cisplatin chemotherapy in stage IIIB non-small cell lung cancer : Results of a phase I/II study. In: International Journal of Radiation Oncology, Biology, Physics. 1991 ; Vol. 20, No. 5. pp. 1047-1052.
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