P2-167: Induction docetaxel and cisplatin followed of bi-weekly docetaxel with concurrent thoracic radiotherapy for stage III non-small cell lung cancer (NSCLC). A phase II study conducted by the Galician Lung Cancer Group (GLCG)

Joaquin R. Casal, Sergio E. Vazquez, Martin Q. Lázaro, Urbano Anido, Jose L. Firvida, Elena Alvarez, Gerardo Huidobro, Isaura Fernandez, Margarita Amenedo, Manolo Caeiro
2007 Journal of Thoracic Oncology  
The most satisfactory treatment for patients with locally advanced NSCLC is combination chemotherapy-radiotherapy (CT-RT). The optimal treatment modalities remain to be determined. Methods: 60 patients (pts) with inoperable locally advanced NSCLC, stage IIIAN2/IIIB (no pleural T4), were included in a phase II study with induction chemotherapy consisting of three cycles of Docetaxel 75 mg/m 2 on D1 and Cisplatin 40 mg/m 2 D1-2 every 3 weeks and, if no surgery, then received concurrent CT-RT with
more » ... Docetaxel 30 mg/m 2 every 2 weeks for four courses, during thoracic conformal radiotherapy (60-66 Gys, 180 cGy/day). The primary objective: overall survival; secondary: progression free survival, response rate (RR) and toxicity. Median follow-up: 9.1 mo. Results: The pts characteristics were: mean age 62.9 yrs (43-74); male/ female: 56/4; ECOG 0/1 in 17/43 pts; stage IIIAN2: 17 pts (28.3%) and stage IIIB 43 pts (71.7%). 56 pts were evaluables for response and 58 pts for toxicity. Induction chemotherapy response: 1 CR and 34 PR (RR 62.5%; CI95%:50-75), 16 SD (28.6%) and 5 PD (8.9%). 6 pts went to surgery: 3 pPR, 1 pSD, 1 pPD and 1 unresectable. 34 pts completed concurrent CT-RT treatment with 6 CR, 21 PR, 4 SD and 3 PD (RR 79.3%; CI95%:66-93). The median time to progression was 13 mo and median overall survival was 14 mo. The progression-free survival and overall survival at 1 year was 52% and 62% respectively. A total of 163 cycles of induction chemotherapy were administered (2.8 per pts), with the main toxicity (NCI-CTC) per pts Grade (g) 1-2/3-4 (%) was as follows: neutropenia 20.6/24.1; anemia 44.8/1.7; nausea/vomiting 39.6/1.7; fatigue 34.5/1.7; diarrhea 22.4/0; allergy 5.2/1.7; one toxic death were scored. The main toxicities (RTOG) in concurrent CT-RT were: g1-2 neutropenia/anemia 30.7/38.4 5% of pts; g1-2/3 esophagitis in 51.2/2.5% and g1-2/3 pneumonitis in 20.5/2.5 % of pts. Conclusions: Docetaxel and Cisplatin induction chemotherapy followed by bi-weekly docetaxel with concurrent thoracic radiotherapy is a feasible treatment option, showing good clinical activity and tolerability for locally advanced NSCLC.
doi:10.1097/01.jto.0000283825.39615.3b fatcat:jdjggzwhzzefxcsw5ifabbuf3m