title: Phase III study comparing second- and third-generation regimens with concurrent thoracic radiotherapy in patients with unresectable stage III non-small-cell lung cancer: West Japan Thoracic Oncology Group WJTOG0105.
abstract: OBJECTIVE
  This phase III trial of concurrent thoracic radiotherapy (TRT) was conducted to compare third-generation chemotherapy with second-generation chemotherapy in patients with unresectable stage III non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Eligible patients received the following treatments: A (control), four cycles of mitomycin (8 mg/m(2) on day 1)/vindesine (3 mg/m(2) on days 1, 8)/cisplatin (80 mg/m(2) on day 1) plus TRT 60 Gy (treatment break for 1 week); B, weekly irinotecan (20 mg/m(2))/carboplatin (area under the plasma concentration-time curve [AUC] 2) for 6 weeks plus TRT 60 Gy, followed by two courses of irinotecan (50 mg/m(2) on days 1, 8)/carboplatin (AUC 5 on day 1); C, weekly paclitaxel (40 mg/m(2))/carboplatin (AUC 2) for 6 weeks plus TRT 60 Gy, followed by two courses of paclitaxel (200 mg/m(2) on day 1)/carboplatin (AUC 5 on day 1).
  
  
  RESULTS
  The median survival time and 5-year survival rates were 20.5, 19.8, and 22.0 months and 17.5%, 17.8%, and 19.8% in arms A, B, and C, respectively. Although no significant differences in overall survival were apparent among the treatment arms, noninferiority of the experimental arms was not achieved. The incidences of grade 3 to 4 neutropenia, febrile neutropenia, and gastrointestinal disorder were significantly higher in arm A than in arm B or C (P < .001). Chemotherapy interruptions were more common in arm B than in arm A or C.
  
  
  CONCLUSIONS
  Arm C was equally efficacious and exhibited a more favorable toxicity profile among three arms. Arm C should be considered a standard regimen in the management of locally advanced unresectable NSCLC.
authors.affiliation: Kinki University Hospital, Osaka-Sayama, Japan. n.yamamoto@scchr.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Kayoko
authors.initials: K
authors.lastname: Tsujino
authors.forename: Miyako
authors.initials: M
authors.lastname: Satouchi
authors.forename: Shinzoh
authors.initials: S
authors.lastname: Kudo
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Hida
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawahara
authors.forename: Koji
authors.initials: K
authors.lastname: Takeda
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sawa
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yokota
authors.forename: Takashi
authors.initials: T
authors.lastname: Seto
authors.forename: Fumio
authors.initials: F
authors.lastname: Imamura
authors.forename: Hideo
authors.initials: H
authors.lastname: Saka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Iwamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Semba
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Chiba
authors.forename: Hisao
authors.initials: H
authors.lastname: Uejima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuoka
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D016685:Mitomycin; D000077146:Irinotecan; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D014751:Vindesine; D002166:Camptothecin