Comparison of toxicity and outcomes of concurrent radiotherapy with carboplatin/paclitaxel (PC) or cisplatin/etoposide (PE) in stage III non-small cell lung cancer (NSCLC).

Authors

null

Mun Sem Liew

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

Organizations

Joint Austin-Ludwig Oncology Unit, Austin Health, Melbourne, Australia, Department of Radiation Oncology, Austin Health, Melbourne, Australia, Maastricht University Medical Center, Maastricht, Netherlands, Ontario Institute for Cancer Research, Toronto, ON, Canada, Dept. of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands

Research Funding

No funding sources reported

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) -

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Citation

J Clin Oncol 31, 2013 (suppl; abstr e18559)

DOI

10.1200/jco.2013.31.15_suppl.e18559

Abstract #

e18559

Abstract Disclosures

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