title: A Phase I study of chemoradiotherapy with use of involved-field conformal radiotherapy and accelerated hyperfractionation for Stage III non-small cell lung cancer: WJTOG 3305.
abstract: OBJECTIVE
  A Phase I study to determine a recommended dose of thoracic radiotherapy using accelerated hyperfractionation for unresectable non-small-cell lung cancer was conducted.
  
  
  METHODS
  Patients with unresectable Stage III non-small-cell lung cancer were treated intravenously with carboplatin (area under the concentration curve 2) and paclitaxel (40 mg/m(2)) on Days 1, 8, 15, and 22 with concurrent twice-daily thoracic radiotherapy (1.5 Gy per fraction) beginning on Day 1 followed by two cycles of consolidation chemotherapy using carboplatin (area under the concentration curve 5) and paclitaxel (200 mg/m(2)). Total doses were 54 Gy in 36 fractions, 60 Gy in 40 fractions, 66 Gy in 44 fractions, and 72 Gy in 48 fractions at Levels 1 to 4. The dose-limiting toxicity, defined as Grade ≥4 esophagitis and neutropenic fever and Grade ≥3 other nonhematologic toxicities, was monitored for 90 days.
  
  
  RESULTS
  Of 26 patients enrolled, 22 patients were assessable for response and toxicity. When 4 patients entered Level 4, enrollment was closed to avoid severe late toxicities. Dose-limiting toxicities occurred in 3 patients. They were Grade 3 neuropathy at Level 1 and Level 3 and Grade 3 infection at Level 1. However, the maximum tolerated dose was not reached. The median survival time was 28.6 months for all patients.
  
  
  CONCLUSIONS
  The maximum tolerated dose was not reached, although the dose of radiation was escalated to 72 Gy in 48 fractions. However, a dose of 66 Gy in 44 fractions was adopted for this study because late toxicity data were insufficient.
authors.affiliation: Department of Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan. tada@msic.med.osaka-cu.ac.jp
authors.forename: Takuhito
authors.initials: T
authors.lastname: Tada
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Chiba
authors.forename: Kayoko
authors.initials: K
authors.lastname: Tsujino
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Fukuda
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Masaki
authors.initials: M
authors.lastname: Kokubo
authors.forename: Shunichi
authors.initials: S
authors.lastname: Negoro
authors.forename: Shinzoh
authors.initials: S
authors.lastname: Kudoh
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuoka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods* / Q000401:mortality; D019583:Dose Fractionation, Radiation; D004334:Drug Administration Schedule; D004941:Esophagitis / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007275:Injections, Intravenous; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D047368:Tumor Burden
chemical_list: D016190:Carboplatin; D017239:Paclitaxel