Joint Austin-Ludwig Oncology Unit, Austin Health, Melbourne, Australia
Mun Sem Liew , Joseph Sia , Samuel John Harris , Alireza Tafreshi , Maud HW Starmans , Malcolm Feigen , Paul C Boutros , Shane White , Allan Solomon Zimet , P. Lambin , Paul Mitchell , Tom John
Background: Concurrent chemoradiotherapy (CCRT) has become the standard of care for patients (pts) with unresectable stage III NSCLC. Although 60Gy of radiotherapy is accepted as the standard radiation dose, the concurrent chemotherapy regimen is idiosyncratic to the institution with PC generally reserved for older and less fit pts. We retrospectively reviewed outcomes and toxicity of two widely used regimens at our institution (Austin Health, Melbourne): weekly PC (Belani et al, 2005) versus (vs) PE given weeks 1 and 5 (SWOG 9019) each with concurrent chest radiotherapy. Methods: Charts from stage III NSCLC pts treated with radical dose CCRT between 2000-2011 were reviewed. Clinical data including demographics, toxicity, and response were reviewed. Results: A total of 83 (PC: 50, PE: 33) pts were treated. PC pts were older [median age (range) 70 year (44-83) vs 63 year (32-76); p=0.001]. Other characteristics were comparable in PC and PE groups (Table). Increased grade (gr) ≥3 neutropenia was seen with PE (39% vs 12%, p=0.008). Other gr ≥3 toxicities were similar including febrile neutropenia, esophagitis and pneumonitis. With a median follow up of 17.2 months (mo), no statistical difference in overall survival (OS) (median PC 21.3 mo vs PE 13.7 mo; p=0.690) and relapse free survival (median PC 12.0 mo vs PE 11.1 mo; p=0.934) were observed. In multivariate analysis, where treatment type and age were included in the model, only more advanced stage predicted poorer OS (p=0.045). Conclusions: PC was more likely to be used in elderly pts. Despite this, PC resulted in significantly less hematological toxicity but achieved similar survival outcomes compared to PE. PC is an acceptable CCRT regimen especially in older pts.
Characteristics | PC (N=50) | PE (N=33) |
---|---|---|
n (%) | n (%) | |
Male | 36 (72) | 20 (61) |
Smoker | 46 (92) | 31 (94) |
ECOG | ||
0 | 10 (20) | 11 (33) |
1 | 36 (72) | 20 (61) |
2 | 4 (8) | 2 (6) |
Charlson morbidity index, median (range) | 3 (2 -6) | 2 (2-5) |
Histology | ||
Squamous | 21 (42) | 11 (33) |
Nonsquamous | 29 (58) | 22 (67) |
Stage | ||
3A | 37 (74) | 19 (58) |
3B | 12 (24) | 13 (39) |
M1 (treated brain metastasis) | 1 (2) | 1 (3) |
Chemo dose intensity, mean % (range) | ||
Platinum | 90 (33-100) | 85 (25-100) |
Etoposide | - | 87 (30-100) |
Taxanes | 86 (17-100) | - |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2021 ASCO Annual Meeting
First Author: Carlos Salinas
2022 ASCO Annual Meeting
First Author: Martin Reck
2022 ASCO Annual Meeting
First Author: Greg Andrew Durm
2023 ASCO Genitourinary Cancers Symposium
First Author: Nacer Abrouk