1212 - Concurrent chemoradiation (CCHRT) with bi-weekly docetaxel and cisplatin and thoracic radiotherapy for stage III non-small cell lung cancer (NSCLC):...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Locally Advanced
Surgery and/or Radiotherapy of Cancer
Presenter Joaquin Casal Rubio
Authors J. Casal Rubio1, B. Taboada2, M. Lazaro3, S. Vazquez4, X.L. Firvida5, M. Vieito Villar6, E. Hernández7, J.E. Castro8, F. Barón6, C. Pena9
  • 1Servicio Oncologia Medica, Complexo Hospitalario Universitario de Vigo, 36200 - Vigo/ES
  • 2Oncoloxia Radioterápica, Hospital Clinico Universitario de Santiago, Santiago de Compostela/ES
  • 3Oncoloxia Médica, Complexo Hospitalario Universitario de Vigo, 36200 - Vigo/ES
  • 4Oncoloxia Médica, Hospital Universitario Lucus Augusti de Lugo, Lugo/ES
  • 5Oncoloxia Médica, Complexo Hospitalario Universitario de Ourense, Ourense/ES
  • 6Dept. Of Medical Oncology, Complejo Hospitalario Universitario de Santiagode Compostela SERGAS, ES-15706 - Santiago de Compostela/ES
  • 7Oncoloxia Radioterápica, Complexo Hospitalario Universitario de Vigo, Vigo/ES
  • 8Oncoloxia Radioterápica, Complexo Hospitalario Universitario de Ourense, Ourense/ES
  • 9Oncología Médica, Complexo Hospitalario de Pontevedra, Pontevedra/ES

Abstract

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

Between May 2009 and March 2012, 43 chemo-naive p with histologically confirmed inoperable locally advanced NSCLC, stage IIIAN2/IIIB (no pleural T4) and adequate lung function (FEV1 > 1, V20 < 25%) were included in a phase II study was based on 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 months.

Results

The p characteristics were: mean age 60 years (34-75); male/female 39/4; ECOG PS 0/1 in 11/32 p; squamous/adeno/large cell carcinoma: 62.8%/27.9%/9.3%; stage IIIAN2 11 p (25.6%) and stage IIIB 32 p (74.4%). 39 p were evaluable for response (in treatment 4 p) and 43 p for toxicity. 39 p completed CChRT and were evaluable with 4 CR, 25 PR (RR 74,4%; 95% CI:60-88), 4 SD (10.2%) and 6 PD (15.4%). The median PFS was 15 months (95% CI: 13-17) and median OS was 19 months (95% CI:13-25). The PFS and OS at 1/2 years were 59%/38% and 85%/46% respectively. A total of 43 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 2.3/13.9; anemia 13.9/0; nausea/vomiting 23.2/2.3; diarrhea 25.5/2.3; febrile neutropenia, 2 p. Main toxicities per p in CChRT (D-C doses: 147, 3.4 per p; mean doses RT: 63,4 Gys) were g1-2/3 (%): neutropenia 25.5/6.9; anemia 43.9/0; nausea/vomiting 18.6/0; fatigue 37.2/4.6; esophagitis 46.5/2.3 and pneumonitis 39.5/0; there were three episodes of hospitalization: febrile neutropenia, 2 p and g3 esophagitis, 1 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 promising survival.

Disclosure

All authors have declared no conflicts of interest.