- 作者：Takuhito Tada ; M.D.&lowast ; ; &dagger ; ; tada@msic.med.osaka-cu.ac.jp ; Yasutaka Chiba ; M.D.&Dagger ; ; Kayoko Tsujino ; M.D.§ ; ; Haruyuki Fukuda ; M.D.?/sup> ; Yasumasa Nishimura ; M.D.¶ ; ; Masaki Kokubo ; M.D. ; Ph.D.&lowast ; &lowast ; ; Shunichi Negoro ; M.D.&dagger ; &dagger ; ; Shinzoh Kudoh ; M.D.&Dagger ; &Dagger ; ; Masahiro Fukuoka ; M.D.§ ; § ; ; Kazuhiko Nakagawa ; M.D. ; Ph.D.¡¬?/sup> ; Yoichi Nakanishi ; M.D.¶ ; ¶ ;
- 关键词：Non&ndash ; small-cell lung cancer ; Chemoradiation ; Three-dimensional conformal radiotherapy ; Accelerated hyperfractionation ; Dose escalation
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：1 May, 2012
- 年：2012
- 卷：83
- 期：1
- 页码：327-331
- 全文大小：209 K
Purpose
A Phase I study to determine a recommended dose of thoracic radiotherapy using accelerated hyperfractionation for unresectable non-small-cell lung cancer was conducted.Methods and Materials
Patients with unresectable Stage III non-small-cell lung cancer were treated intravenously with carboplatin (area under the concentration curve 2) and paclitaxel (40 mg/m2) on Days 1, 8, 15, and 22 with concurrent twice-daily thoracic radiotherapy (1.5 Gy per fraction) beginning on Day 1 followed by two cycles of consolidation chemotherapy using carboplatin (area under the concentration curve 5) and paclitaxel (200 mg/m2). Total doses were 54 Gy in 36 fractions, 60 Gy in 40 fractions, 66 Gy in 44 fractions, and 72 Gy in 48 fractions at Levels 1 to 4. The dose-limiting toxicity, defined as Grade ? esophagitis and neutropenic fever and Grade ? other nonhematologic toxicities, was monitored for 90 days.
Results
Of 26 patients enrolled, 22 patients were assessable for response and toxicity. When 4 patients entered Level 4, enrollment was closed to avoid severe late toxicities. Dose-limiting toxicities occurred in 3 patients. They were Grade 3 neuropathy at Level 1 and Level 3 and Grade 3 infection at Level 1. However, the maximum tolerated dose was not reached. The median survival time was 28.6 months for all patients.
Conclusions
The maximum tolerated dose was not reached, although the dose of radiation was escalated to 72 Gy in 48 fractions. However, a dose of 66 Gy in 44 fractions was adopted for this study because late toxicity data were insufficient.