Concurrent chemoradiation (CChRT) with bi-weekly docetaxel and cisplatin and thoracic radiotherapy for stage III non-small cell lung cancer (NSCLC): A phase II study from the Galician Lung Cancer Group.

Authors

null

Joaquin Casal Rubio

Complexo Hospitalario Universitario de Vigo, Vigo, Spain

Joaquin Casal Rubio , EM Brozos , Martin Lázaro Quintela , Sergio Vazquez-Estevez , Jl Firvida , MB Taboada , M Caeiro , JE Castro , Maria Vieito Villar , Clara Senin Estor , MJ Villanueva , Silvia Varela Ferreiro , MC Areses , C Pena , P Calvo , E. Hernandez , N. Martinez , Urbano Anido , Gerardo Huidobro

Organizations

Complexo Hospitalario Universitario de Vigo, Vigo, Spain, Complexo Hospitalario Universitario de Santiago, Santiago, Spain, Hospital Universitario Lucus Augusti, Lugo, Spain, Complexo Universitario de Ourense, Ourense, Spain, Complexo Universitario de Santiago, Santiago, Spain, Complexo Hospitalario Universitario de Ourense, Ourense, Spain, Hospital Clinico Universitario, Santiago de Compostela, Spain, Complexo Hospitalario Universiotario de Pontevedra, Vigo, Spain

Research Funding

No funding sources reported

Background: CChRT is recommended as the evidence-based approach for the management of patients (p) with locally advanced stage III NSCLC and a good performance status, although a clearly superior regimen has not been identified. The aim of our study was to evaluate the effectiveness and toxicities of CChRT with bi-weekly docetaxel (D) and cisplatin (C) and thoracic radiotherapy. Methods: 50 p with histologically confirmed inoperable locally advanced NSCLC, stage IIIAN2/IIIB (no pleural T4), PS 0-1 and adequate lung function (FEV1 > 1.1, V20 < 25%) were included: one cycle of D 75 mg/m2 on day 1 and C 40 mg/m2 days 1-2 followed at 21 days by CChRT with bi-weekly D 40 mg/m2 and C 40 mg/m2 for four courses, during conformal thoracic radiotherapy (66 Gys, 180 cGy/day). The primary objective was overall survival (OS); secondary objectives were progression free survival (PFS), response rate (RR) and toxicity. Median follow-up: 14,5 months. Results: The p characteristics were: mean age 59,1 years (34-75); male/female 44/6; squamous/adeno/large cell carcinoma: 52%/34%/14%; stage IIIAN2 14 p (28%) and stage IIIB 36 p (72%). All p were evaluable for response and toxicity. RR: 4 CR, 36 PR (RR 80%; 95% CI:69-91), 4 SD (8%) and 6 PD (12%). The median PFS was 13 months (95% CI:8-18) and median OS was 19 months (95% CI:14-24). The PFS and OS at 1/2 years were 52%/30% and 79%/40% respectively. A total of 50 cycles of D-C induction chemotherapy were given; main toxicities (NCI-CTC 3.0) per p Grade (g) 1-2/3-4 (%) were as follows: neutropenia 2/16; anemia 12/0; nausea/vomiting 28/2; diarrhea 22/4; there were two episodes of febrile neutropenia. Main toxicities per p in CChRT (D-C doses: 192, 3.8 per p; mean doses RT: 64,6 Gys) were g1-2/3 (%): neutropenia 28/6; anemia 60/0; esophagitis 52/4 and pneumonitis 34/0; there were four episodes of hospitalization: febrile neutropenia, 2 p and g3 esophagitis, 2 p. Conclusions: CChRT with bi-weekly docetaxel and cisplatin and thoracic radiotherapy is a feasible treatment option for inoperable locally advanced stage III NSCLC, showing good clinical efficacy and tolerability with acceptable long-term survival.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer - Non-small Cell Local-regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Citation

J Clin Oncol 31, 2013 (suppl; abstr 7549)

DOI

10.1200/jco.2013.31.15_suppl.7549

Abstract #

7549

Poster Bd #

21C

Abstract Disclosures