Concurrent chemoradiotherapy with cisplatin and vinorelbine for stage III non-small cell lung cancer.
BACKGROUND
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 on day 1 and VNR 20 mg/m 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.
Thoracic Oncology Division, National Cancer Center Hospital East, Kashiwa, Japan.
Yoichi
Y
Naito
Kaoru
K
Kubota
Keiji
K
Nihei
Tomonori
T
Fujii
Kiyotaka
K
Yoh
Seiji
S
Niho
Koichi
K
Goto
Hironobu
H
Ohmatsu
Nagahiro
N
Saijo
Yutaka
Y
Nishiwaki
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011838:Radiation-Sensitizing Agents; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077235:Vinorelbine
D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine