Concurrent chemoradiotherapy with cisplatin and vinorelbine for stage III non-small cell lung cancer

Introduction: Concurrent chemoradiotherapy with full doses of cisplatin-based chemotherapy is standard treatment for inoperable stage III non-small cell lung cancer (NSCLC). Although many platinum-based two drug combinations with third-generation agents are difficult to combine fully with thoracic radiotherapy (TRT), a phase I study reported a full dose of cisplatin (CDDP) plus 80% dose of vinorelbine (VNR) was successfully combined with concurrent TRT. Methods: Between October 2000 and October 2004, 73 patients with inoperable stage III NSCLC treated with CDDP, VNR, and concurrent TRT were retrospectively analyzed. Patients were treated with CDDP 80 mg/m(2) on day 1 and VNR 20 mg/m(2) on days 1 and 8 every 4 weeks. Radiotherapy was administered concurrently in cycle 1. The total radiation dose was 60 Gy in 30 fractions. Common Terminology Criteria for Adverse Events version 3.0 were used to assess treatment-related adverse events. Results: Median age was 63 years (40-78). Twenty-nine patients had adenocarcinoma, 63 were male, 47 ECOG PS 1, and 47 stage IIIB. Median chemotherapy cycle was 2.0. Objective response rate was 93% and median survival time was 21 months. Three-year overall survival rate was 33%. Infield control rate was 71%. The most common grade 3 or 4 adverse event was leukocytopenia (67%). Only 3 patients (4%) experienced grade 3 esophagitis. One patient died of radiation pneumonitis 87 days after completion of chemoradiotherapy. Conclusions: Concurrent chemoradiotherapy with CDDP and VNR was highly active and well-tolerated. This regimen could be used as a control arm in future trial for stage III NSCLC.