Phase II study of concurrent thoracic radiotherapy in combination with weekly paclitaxel plus carboplatin in locally advanced non-small cell lung cancer: LOGIK0401

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• 作者：Koichi Takayama (1)
  Koji Inoue (2)
  Shoji Tokunaga (3)
  Takemasa Matsumoto (4)
  Tsukasa Oshima (5)
  Masayuki Kawasaki (6)
  Tomotoshi Imanaga (7)
  Mutsuo Kuba (8)
  Masafumi Takeshita (2)
  Taishi Harada (1)
  Yoshiyuki Shioyama (9)
  Yoichi Nakanishi (1)
  
• 关键词：Locally advanced NSCLC ; Chemoradiotherapy ; Consolidation chemotherapy ; Carboplatin ; Paclitaxel ; Vinorelbine
• 刊名：Cancer Chemotherapy and Pharmacology
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：72
• 期：6
• 页码：1353-1359
• 全文大小：
• 作者单位：Koichi Takayama (1)
  Koji Inoue (2)
  Shoji Tokunaga (3)
  Takemasa Matsumoto (4)
  Tsukasa Oshima (5)
  Masayuki Kawasaki (6)
  Tomotoshi Imanaga (7)
  Mutsuo Kuba (8)
  Masafumi Takeshita (2)
  Taishi Harada (1)
  Yoshiyuki Shioyama (9)
  Yoichi Nakanishi (1)
  
  1. Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, Japan
  2. Kitakyushu Municipal Medical Center, Kitakyushu, Japan
  3. Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
  4. Department of Respiratory Medicine, Fukuoka University, Fukuoka, Japan
  5. Kyushu Kosei Nenkin Hospital, Kitakyushu, Japan
  6. Fukuoka Higashi Medical Center, Koga, Japan
  7. Steel Memorial Yawata Hospital, Kitakyushu, Japan
  8. National Hospital Organization Okinawa National Hospital, Ginowan, Japan
  9. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, Japan
  
• ISSN：1432-0843

文摘

Objectives Concurrent chemoradiotherapy for regionally advanced stage III non-small cell lung cancer is the standard treatment method. However, the clinical implications of consolidation chemotherapy following chemoradiation have been unclear. Therefore, we conducted a phase II study of concurrent weekly carboplatin plus paclitaxel treatment in combination with radiotherapy followed by vinorelbine monotherapy. The primary endpoint was the 1-year survival rate. Patients and methods Chemonaive PS 0 patients with stage IIIA/B NSCLC were enrolled. During the concurrent chemoradiation phase, patients were treated with weekly paclitaxel 40mg/m2 plus carboplatin AUC 2. The primary tumor and involved nodes received 60Gy in 2-Gy fractions over 6weeks. During the consolidation phase, vinorelbine 25mg/m2 on days 1 and 8 was repeated for three cycles. Results A total of 40 eligible patients (72.5% male; median age, 63years; range 294years) were analyzed for efficacy. Squamous cell carcinoma was the most common histology (47.5%), and more patients had clinical stage IIIB (55%) cancer. The average radiation dose was 56.5Gy, and the average number of carboplatin plus paclitaxel cycles was 4.93. Seventeen patients proceeded to the consolidation chemotherapy phase, and 14 completed three cycles of vinorelbine monotherapy. The objective response rate was 75.0%, including 1 patient who achieved a complete response. Progression-free survival and overall survival (OS) were 46weeks [95% confidence interval (CI) 314weeks] and 110weeks (95% CI 9084weeks), respectively. The OS rate at 1 and 2years was 85.0% (95% CI 69.63.0%) and 53.9% (95% CI 37.18.0%), respectively. Conclusion Concurrent chemoradiation with weekly carboplatin and paclitaxel followed by vinorelbine consolidation is effective for stage III non-small cell lung cancer and shows a generally mild toxicity profile.