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Randomized phase II study of concurrent cisplatin/etoposide or paclitaxel/carboplatin and thoracic radiotherapy in patients with stage III non-small cell lung cancer.

AbstractOBJECTIVE:
To evaluate the activity and safety of concurrent thoracic radiotherapy (TRT) plus weekly paclitaxel/carboplatin (PC) regimen compared with widely used cisplatin/etoposide (PE) regimen in patients with unresectable stage III non-small cell lung cancer (NSCLC).
PATIENTS AND METHODS:
Patients were randomly assigned to receive the following treatments: PE arm, cisplatin (50mg/m(2)) on days 1, 8, 29, and 36 and etoposide (50 mg/m(2)) on days 1-5 and 29-33 plus 60 Gy of TRT; PC arm, weekly concurrent carboplatin (AUC = 2) and paclitaxel (45 mg/m(2)) plus 60 Gy of TRT.
RESULTS:
A total of 65 patients were randomized (PE arm, n = 33; PC arm, n = 32). The 3-year overall survival (OS) was significantly better in the PE arm than in the PC arm (33.1% vs. 13%, P = .04). The incidence of Grade 3/4 neutropenia was 78.1% in the PE arm and 51.5% in the PC arm (P = .05). The rate of Grade 2 or greater radiation pneumonitis was 25% in the PE arm and 48.5% in the PC arm (P = .09).
CONCLUSIONS:
Compared to PE regimen, weekly PC regimen cannot be recommended since it failed to achieve an improvement in either OS or PFS.
AuthorsLuhua Wang, Shixiu Wu, Guangfei Ou, Nan Bi, Wenfeng Li, Hua Ren, Jianzhong Cao, Jun Liang, Junling Li, Zongmei Zhou, Jima Lv, Xiangru Zhang
JournalLung cancer (Amsterdam, Netherlands) (Lung Cancer) Vol. 77 Issue 1 Pg. 89-96 (Jul 2012) ISSN: 1872-8332 [Electronic] Ireland
PMID22418243 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Etoposide
  • Carboplatin
  • Paclitaxel
  • Cisplatin
Topics
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Carboplatin (administration & dosage)
  • Carcinoma, Non-Small-Cell Lung (mortality, pathology, therapy)
  • Chemoradiotherapy (adverse effects)
  • Cisplatin (administration & dosage)
  • Disease-Free Survival
  • Esophagitis (etiology)
  • Etoposide (administration & dosage)
  • Female
  • Humans
  • Lung Neoplasms (mortality, pathology, therapy)
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Neutropenia (etiology)
  • Paclitaxel (administration & dosage)
  • Radiation Pneumonitis (chemically induced)
  • Treatment Outcome

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