Weekly Paclitaxel/Carboplatin with Concurrent Thoracic Radiation Followed by Paclitaxel/ Carpoplatin Consolidation for Postoperative Stage II and IIIA Non-Small-Cell Lung Cancer
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- Category: Vol. 77, June 2009
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Weekly Paclitaxel/Carboplatin with Concurrent Thoracic Radiation Followed by Paclitaxel/ Carpoplatin Consolidation for Postoperative Stage II and IIIA Non-Small-Cell Lung Cancer,KHALED NAGIB, TAREK HUSSEIN, IMAN FOUAD, IMAN AL-SHARAWY, MOHAMAD SABRY, AHMAD EZZAT, WALID ABDEL-MONEEM and AHMAD AL-NORY
Abstract
Purpose: Recent studies have suggested the superiority of concurrent chemoradiotherapy and the efficacy of paclitax-el/carboplatin in adjuvant non-small-cell lung cancer (NSCLC). In view of those results, we conducted this phase II trial to examine the safety and efficacy of administration of radiosen-sitizing paclitaxel/carboplatin weekly with concurrent thoracic radiation therapy (XRT) followed by consolidation paclitax-el/carboplatin for stage II & IIIA NSCLC.
Patients and Methods: Patients with resected NSCLC, pathological stage II or IIIA, N1-N2 with or without positive margin, received paclitaxel/carboplatin weekly during thoracic radiotherapy. All patients received 50.4Gy in 28 fractions for 6 weeks (1.8Gy/d, 5 days/wk). A boost of 10.8Gy in six fractions was given for extracapsular nodal extension or positive margin. Four weeks after radiotherapy, the patients received two courses of consolidation paclitaxel/carboplatin every 3 weeks.
Results: Treatment compliance was acceptable, with 96% compliance for radiation therapy and 92% for chemotherapy completion. The median duration of follow-up was 30 months. The 3-year actuarial survival and progression-free survival rates were 56% and 44%, respectively. Loco-regional failure was a component of first failure in 24% of patients. Toxicities were acceptable.
Conclusion: The results of this study suggest that weekly paclitaxol/carboplatin concurrent with radiotherapy is safe and acceptable adjuvant treatment for stage II and IIIA resected NSCLC patients. A randomized phase III trial comparing this treatment regimen with standard therapy seems warranted.