title: Analysis of a novel protocol of combined induction chemotherapy and concurrent chemoradiation in unresected non-small-cell lung cancer: a ten-year experience with vinblastine, Cisplatin, and radiation therapy.
abstract: BACKGROUND
  The London Regional Cancer Program (LRCP) uses a unique schedule of induction plus concurrent chemoradiation, termed VCRT (vinblastine, cisplatin, and radiation therapy), for the treatment of a subset of unresectable stage IIIA and IIIB non-small-cell lung cancer (NSCLC). This analysis was conducted to better understand the outcomes in VCRT-treated patients.
  
  
  METHODS
  We report a retrospective analysis of a large cohort of patients who underwent VCRT at the LRCP over a 10-year period, from 1996 to 2006. The analysis focused on OS, toxicities, and the outcomes from completion surgery in a small subset of patients.
  
  
  RESULTS
  A total of 294 patients were included and 5-year OS, determined using Kaplan-Meier methodology, was 19.8% with a MST of 18.2 months. Reported grade 3-4 toxicities included neutropenia (39%), anemia (10%), pneumonitis (1%), and esophagitis (3%). Significant differences in survival between groups of patients were demonstrated with log-rank tests for completion surgery, use of radiation therapy, and cisplatin dose. Similarly, Univariate Cox regression showed that completion surgery, use of radiation therapy, cisplatin dose, and vinblastine dose were associated with increased survival.
  
  
  CONCLUSIONS
  This retrospective analysis of a large cohort of patients reveals an OS for VCRT comparable to that reported in the literature for other current combined chemoradiation protocols. The success of this protocol seems to be dose dependent and the outcomes in those who underwent completion surgery suggests that pathologic complete remission is possible for IIIA and IIIB NSCLC.
authors.affiliation: University of Western Ontario, Canada.
authors.forename: Eugenie
authors.initials: E
authors.lastname: Waters
authors.forename: Brian
authors.initials: B
authors.lastname: Dingle
authors.forename: George
authors.initials: G
authors.lastname: Rodrigues
authors.forename: Mark
authors.initials: M
authors.lastname: Vincent
authors.forename: Robert
authors.initials: R
authors.lastname: Ash
authors.forename: Rashid
authors.initials: R
authors.lastname: Dar
authors.forename: Richard
authors.initials: R
authors.lastname: Inculet
authors.forename: Walter
authors.initials: W
authors.lastname: Kocha
authors.forename: Richard
authors.initials: R
authors.lastname: Malthaner
authors.forename: Michael
authors.initials: M
authors.lastname: Sanatani
authors.forename: Larry
authors.initials: L
authors.lastname: Stitt
authors.forename: Brian
authors.initials: B
authors.lastname: Yaremko
authors.forename: Jawaid
authors.initials: J
authors.lastname: Younus
authors.forename: Edward
authors.initials: E
authors.lastname: Yu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D002945:Cisplatin