title: Effects of selenomethionine on acute toxicities from concurrent chemoradiation for inoperable stage III non-small cell lung cancer.
abstract: OBJECTIVE
  To prospectively determine the safety and tolerability of oral L-selenomethionine (SLM) with concurrent chemoradiation (CCRT) for Stage III non-small cell lung cancer (NSCLC) and estimate if the incidence and/or severity of adverse events could be reduced by its use.
  
  
  METHODS
  Sixteen patients with stage III NSCLC were accrued to this single arm, phase II study. CCRT consisted of radiation given at 2 Gy per fraction for 30-33 fractions, 5 d per week with concurrent weekly IV paclitaxel 50 mg/m(2) followed by carboplatin dosed at an area under the time-concentration curve of 2. SLM was dosed in a loading phase at 4800 μg twice daily for one week prior to CCRT followed by once daily dosing during treatment.
  
  
  RESULTS
  No selenium-related toxicity was observed. Analysis revealed grade 3 or higher esophagitis in 3 of 16 patients (19%), pneumonitis in 0, leukopenia in 2 (12.5%), and anemia in 1 (6%); the latter two were significantly reduced when compared to the protocol-stated expected rate of 35% (P = 0.045 for leukopenia, and P < 0.01 for anemia). Median overall survival was 14.9 mo and median failure-free survival was 9 mo (95%CI: 3.3-21.5).
  
  
  CONCLUSIONS
  There may be some protective benefit of selenium in the setting of CCRT for inoperable NSCLC. The data suggests decreased rates of myelosuppression when compared to similarly-treated historical and contemporary controls. Further evaluation of selenium in this setting may be warranted.
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Mix
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Nithya
authors.initials: N
authors.lastname: Ramnath
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Jorge
authors.initials: J
authors.lastname: Gomez
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Charles
authors.initials: C
authors.lastname: de Groot
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Saju
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Shiva
authors.initials: S
authors.lastname: Dibaj
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Wei
authors.initials: W
authors.lastname: Tan
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Youcef
authors.initials: Y
authors.lastname: Rustum
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Jameson
authors.affiliation: Michael Mix, Jorge Gomez, Saju Rajan, Anurag K Singh, Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, United States.
authors.forename: Anurag K
authors.initials: AK
authors.lastname: Singh
keywords: Chemoprotective; Radioprotector; Radiotherapy; Selenium; Toxicity