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 Cytotoxic agents
Surgical oncology
Non-small-cell lung cancer
Therapy
Biological therapy
Radiation oncology
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.