1213 - Acute toxicity of full-dose cisplatin-etoposide concurrently with high-dose hypofractionated chest radiotherapy for stage III non-small cell lung ca...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Cytotoxic agents
Complications/Toxicities of treatment
Surgical oncology
Non-small-cell lung cancer
Biological therapy
Radiation oncology
Presenter Dirk De Ruysscher
Authors D. De Ruysscher1, W. van Elmpt2, R. Wanders3, A. van Baardwijk3, A.C. Dingemans4, B. Reymen3, G. Bootsma5, P. Lambin6, J. Sonke7, J. Belderbos7
  • 1Radiation Oncology, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 2Maastricht University Medical Centre, NL-6229ET - Maastricht/NL
  • 3Maastro Clinic, Maastricht University Medical Center (MUMC), 6202 AZ - Maastricht/NL
  • 4Pulmonology, Maastricht University Medical Center (MUMC), NL-6202 AZ - Maastricht/NL
  • 5Pulmonology, Atrium Medical Center Heerlen, Heerlen/NL
  • 6Department Of Radiation Oncology (maastro), Grow, Maastricht University Medical Centre, Maastricht/NL
  • 7Radiation Oncology, Netherlands Cancer Institute, Amsterdam/NL



Full-dose concurrent platinum-based doublet chemotherapy and 2 Gy/day radiotherapy is the first choice treatment for most patients with stage III NSCLC. No prospective data are available on the acute toxicity of full-dose chemotherapy and high-dose hypofractionated accelerated radiotherapy. Here we report on a subset of patients included in the PET-boost trial that could not be randomised because dose escalation to the primary tumour over 72 Gy/ 24 fractions was not possible because of OAR constraints.


Patients received cisplatin 80 mg/m2 on day 1 and etoposide 100 mg/m2 on days 1-3 every 21 days for a total of three cycles. At day 1 of the second chemotherapy cycle, radiotherapy to the primary tumour and the involved lymph nodes was delivered (66 Gy /24 QD fractions of 2.75 Gy). Toxicity was evaluated weekly and scored according to CTCAE3.0. We considered the treatment safe when at maximum 5/12 developed G3 acute toxicity, reversible in at least 4/5 within 8 weeks post-therapy.


12 patients, 10 males, 2 females, mean age 66.9 years with stage III NSCLC were included. Mean PTV dose: 64.9 Gy. Mean fractions: 23.6. Mean OTT: 32.6 days. Mean MLD: 19.2 Gy, mean mean oesophageal dose 30.7 Gy, mean max oesophageal dose 60.4 Gy. Median follow-up: 9.9 months (range 3.3-15.1). G2 dyspnea: 1 (8.3 %). Maximal oesophagitis: G1: 2 (16.7 %), G2: 6 (50.0 %), G3: 4 (33.3 %), all recovering to G0 within 6 weeks post-treatment.


Full-dose cisplatin-etoposide was safely combined with high-dose hypofractionated accelerated radiotherapy.


All authors have declared no conflicts of interest.