title: Concurrent gemcitabine and 3D radiotherapy in patients with stage III unresectable non-small cell lung cancer.
abstract: BACKGROUND
  Stage III unresectable non-small cell lung cancer (NSCLC) is preferably treated with concurrent schedules of chemoradiotherapy, but none is clearly superior Gemcitabine is a radiosensitizing cytotoxic drug that has been studied in phase 1 and 2 studies in this setting. The aim of this study was to describe outcome and toxicity of low-dose weekly gemcitabine combined with concurrent 3-dimensional conformal radiotherapy (3D-CRT).
  
  
  METHODS
  Treatment consisted of two cycles of a cisplatin and gemcitabine followed by weekly gemcitabine 300 mg/m2 during 5 weeks of 3D-CRT, 60 Gy in 5 weeks (hypofractionated-accelerated). Overall survival (OS), progression-free survival (PFS), and treatment related toxicity according to Common Toxicity Criteria of Adverse Events (CTCAE) version 3.0 were assessed.
  
  
  RESULTS
  Between February 2002 and August 2008, 318 patients were treated. Median age was 64 years (range 36-86); 72% were male, WHO PS 0/1/2 was 44/53/3%. Median PFS was 15.5 months (95% confidence interval [CI], 12.9-18.1) and median OS was 24.6 months (95% CI., 21.0-28.1). Main toxicity (CTCAE grade ≥3) was dysphagia (12.6%), esophagitis (9.6%), followed by radiation pneumonitis (3.0%). There were five treatment related deaths (1.6%), two due to esophagitis and three due to radiation pneumonitis.
  
  
  CONCLUSIONS
  Concurrent low-dose gemcitabine and 3D-CRT provides a comparable survival and toxicity profile to other available treatment schemes for unresectable stage III.
authors.affiliation: University of Groningen and Department of Pulmonary Diseases, University Medical Center Groningen, Hanzeplein 1, P,O, Box 30,001, Groningen 9700 RB, The Netherlands. g.s.m.a.kerner@umcg.nl.
authors.forename: Gerald S M A
authors.initials: GS
authors.lastname: Kerner
authors.forename: Leon F A
authors.initials: LF
authors.lastname: van Dullemen
authors.forename: Erwin M
authors.initials: EM
authors.lastname: Wiegman
authors.forename: Joachim
authors.initials: J
authors.lastname: Widder
authors.forename: Edwin
authors.initials: E
authors.lastname: Blokzijl
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Driever
authors.forename: John W G
authors.initials: JW
authors.lastname: van Putten
authors.forename: Jeroen J W
authors.initials: JJ
authors.lastname: Liesker
authors.forename: Tineke E J
authors.initials: TE
authors.lastname: Renkema
authors.forename: Remge M
authors.initials: RM
authors.lastname: Pieterman
authors.forename: Marc J F
authors.initials: MJ
authors.lastname: Mertens
authors.forename: Thijo J N
authors.initials: TJ
authors.lastname: Hiltermann
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage*; D020266:Radiotherapy, Conformal; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D011838:Radiation-Sensitizing Agents; D003841:Deoxycytidine; D014747:Vinblastine; D016190:Carboplatin; D002945:Cisplatin; D000093542:Gemcitabine