Efficacy and Toxicity of Chemoradiotherapy with Carboplatin and Irinotecan Followed by Consolidation Docetaxel for Unresectable Stage III Non-small Cell Lung Cancer

被引:18
作者
Bastos, Bruno R. [1 ]
Hatoum, Georges F. [2 ]
Walker, Gail R. [3 ]
Tolba, Khaled [1 ]
Takita, Christiane [2 ]
Gomez, Jorge [1 ]
Santos, Edgardo S. [1 ]
Lopes, Gilberto [1 ]
Raez, Luis E. [1 ]
机构
[1] Univ Miami, Miller Sch Med, Sylvester Comprehens Canc Ctr, Div Hematol Oncol, Miami, FL 33136 USA
[2] Univ Miami, Miller Sch Med, Sylvester Comprehens Canc Ctr, Dept Radiat Oncol, Miami, FL 33136 USA
[3] Univ Miami, Miller Sch Med, Sylvester Comprehens Canc Ctr, Div Biostat, Miami, FL 33136 USA
关键词
DOSE-VOLUME HISTOGRAM; SPLIT-COURSE RADIOTHERAPY; RADIATION PNEUMONITIS; CONCURRENT CHEMORADIOTHERAPY; THORACIC RADIATION; PHASE-III; CISPLATIN; GUIDELINES; ETOPOSIDE; ESCALATION;
D O I
10.1097/JTO.0b013e3181ce3e00
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: In 2003, consolidation docetaxel was a promising concept for unresectable stage IIIA/B nonsmall cell lung cancer (NSCLC). To test the hypothesis that chemoradiotherapy with carboplatin and irinotecan followed by consolidation docetaxel would be feasible and clinically active, we conducted a phase II study. Methods: Thirty-two patients with unresectable stage IIIA/B NSCLC received irinotecan (30 mg/m(2)) and carboplatin dosed to a target area under the concentration curve of 2, each administered weekly for 7 weeks. Concurrent radiotherapy was administered more than 7 weeks to a total dose of 63 Gy in 35 fractions. Consolidation docetaxel (75 mg/m(2)) was administered every 3 weeks for 3 doses 4 weeks after chemoradiotherapy. The primary end point was objective response rate by RECIST. Results: Complete responses occurred in 4 patients and partial responses occurred in 14, for an objective response rate of 56.3% (95% confidence interval [CI], 37.7-73.6%). Median progression-free survival was 6.5 months (95% CI, 4.6-13.5); median duration of survival was 14.8 months (95% CI, 6.9-27.3). The most common hematologic toxicity was leukopenia, which were grade 3 or 4 in 16 patients (50%). Radiation pneumonitis (grade >= 2) occurred in 13 of 31 treated patients (42%). Conclusions: These findings suggested that concurrent chemoradiotherapy with carboplatin and irinotecan followed by consolidation docetaxel is clinically active based on median survival in patients with unresectable stage III NSCLC; however, the 42% incidence of clinical radiation pneumonitis was unexpected and warrants further investigation to determine the mechanism and preventive strategies.
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收藏
页码:533 / 539
页数:7
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