title: Results from a single institution phase II trial of concurrent docetaxel/carboplatin/radiotherapy followed by surgical resection and consolidation docetaxel/carboplatin in stage III non-small-cell lung cancer.
abstract: BACKGROUND
  The optimal treatment of locally advanced non-small-cell lung cancer (NSCLC) remains controversial. We hypothesized that using a trimodality approach in selected patients with stage IIIA/IIIB disease would be both feasible and efficacious with reasonable toxicity.
  
  
  METHODS
  We enrolled 13 patients with resectable stage III NSCLC on a prospective phase II trial of trimodality therapy. Induction treatment consisted of weekly docetaxel 20 mg/m(2) and weekly carboplatin at an area under curve (AUC) of 2 concurrent with 45 Gy thoracic radiotherapy. Resection was performed unless felt to be unsafe or if patients had progressive disease. Postoperative consolidation consisted of docetaxel 75 mg/m(2) and carboplatin at an AUC of 6 every 3 weeks for 3 cycles with growth factor support.
  
  
  RESULTS
  All patients responded to induction chemoradiotherapy as measured by total gross tumor volume reductions of 43% on average (range, 27%-64%). Twelve patients underwent resection of the tumor and involved nodes, yielding a resectability rate of 92%. The primary endpoint of 2-year overall survival (OS) was 72% (95% confidence interval [CI], 36%-90%), and 2-year progression-free survival (PFS) was 36% (95% CI, 9%-64%). The maximal toxicity observed per patient was grade II in 5 patients (38%); grade III in 7 patients (54%); grade IV in 1 patient (8%); and grade V in none.
  
  
  CONCLUSIONS
  This trimodality approach resulted in promising outcomes with reasonable toxicity in carefully selected patients with stage III NSCLC at a single institution.
authors.affiliation: Department of Medicine, Division of Oncology, Stanford University, CA, USA.
authors.forename: Millie
authors.initials: M
authors.lastname: Das
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Donington
authors.forename: James
authors.initials: J
authors.lastname: Murphy
authors.forename: Margaret
authors.initials: M
authors.lastname: Kozak
authors.forename: Neville
authors.initials: N
authors.lastname: Eclov
authors.forename: Richard I
authors.initials: RI
authors.lastname: Whyte
authors.forename: Chuong D
authors.initials: CD
authors.lastname: Hoang
authors.forename: Lisa
authors.initials: L
authors.lastname: Zhou
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
authors.forename: Billy W
authors.initials: BW
authors.lastname: Loo
authors.forename: Heather
authors.initials: H
authors.lastname: Wakelee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019540:Area Under Curve; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin