Comparison of induction chemotherapy before radiotherapy with radiotherapy only in patients with locally advanced squamous cell carcinoma of the lung

Brodin, Ola; E, Nõu; Mercke, Claes; Cj, Lindén; Lundström, Ronnie; Arwidi, Å.; Brink, Jeromy S.; Ringborg, Ulrik

doi:10.1016/0959-8049(96)00212-2

Cited by 37 publications

(8 citation statements)

References 25 publications

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“…Although radiotherapy was applied sparingly either alone or in combination with chemotherapy for non-smallcell lung cancer, its use has doubled in the last few decades [100]. Adjuvant chemotherapy produces a significant but clinically small advantage for nonsmall-cell lung cancer patients and should still be considered experimental [119,123]. Typing of oncogenes or tumour suppressor genes may provide a more accurate diagnosis and, therefore, facilitate the planning of suitable therapeutic approaches, e.g.…”

Section: Non-small-cell Lung Cancermentioning

confidence: 99%

Trends in incidence and prognosis of the histological subtypes of lung cancer in North America, Australia, New Zealand and Europe

2001

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Section: Non-small-cell Lung Cancermentioning

confidence: 99%

Trends in incidence and prognosis of the histological subtypes of lung cancer in North America, Australia, New Zealand and Europe

2001

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“…The addition of chemotherapy before or concurrently with irradiation may slightly improve the survival, but discouraging results have been also reported by randomized trials (Mattson et al, 1988;Dillman et al, 1990;Morton et al, 1991;Le Chevalier et al, 1992;Brodin et al, 1996). Forty-five per cent of patients with locally advanced disease die from local recurrence without distant metastasis, which suggests that effective local therapy may prolong disease-free survival or even cure a subset of patients with non-metastasizing tumour phenotype (Koukourakis et al, 1995).…”

mentioning

confidence: 97%

Concurrent conventionally factionated radiotherapy and weekly docetaxel in the treatment of stage IIIb non-small-cell lung carcinoma

et al. 1999

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Summary Docetaxel has shown remarkable radiosensitizing in vitro properties. In a previous phase I/II dose escalation study in nonsmall-cell lung cancer (NSCLC) we observed a high response rate after concomitant boost radiotherapy and weekly docetaxel. The maximum tolerated dose was 30 mg m -2 week -1 . In the present phase II study we evaluated whether weekly docetaxel and conventionally fractionated radiotherapy could be better tolerated and equally effective in the treatment of locally advanced NSCLC. Thirty-five patients with T3, T4/N2, T3/M0-staged disease were recruited. Docetaxel (30 mg m -2 ) was given as a 30 min infusion once a week. Asthenia and radiation-induced oesophagitis were the main side-effects of the regimen enforcing 2-week treatment delay in 6/35 (17%) patients and minor delay (3-7 days) in another 11/35 (31%) patients. Neutrophil, platelet and haemoglobin toxicity was minimal, but pronounced lymphocytopenia was observed. Complete response (CR) of the chest disease was observed in 12/35 (34%) patients and partial response in 16/35 (46%). Although not statistically significant (P = 0.19), a higher CR rate (8/18; 44%) was observed in patients who accomplished their therapy within the scheduled treatment time (44-47 days) as compared to patients that interrupted their treatment for several days due to treatment-related toxicity (CR 4/17; 23%). The overall survival and the local progression-free survival at 1 year was 48% and 60% respectively. We conclude that docetaxel combination with radiotherapy is a promising approach for the management of locally advanced NSCLC that results in high CR rate. Further trials with docetaxel-based radiochemotherapy should integrate accelerated radiotherapy together with cytoprotection.

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“…Indirect observations investigating across seven sequential studies is that positive studies were platinum based, used at least doublets of cisplatin and vinblastin and high continuous doses of conventionally fractionated radiotherapy to at least 60 Gy. [11][12][13][14][15][16][17] Examining randomized concurrent chemotherapy studies, the positive studies provided improvements of 2-10 months in median survival and approximately 10% benefit in 2-year survival to approximately 25-35%. [18][19][20][21][22][23][24][25] All were platinum based, with no clear advantage to cisplatin or carboplatin, but positive studies were more likely to use doublets (containing etoposide), were more likely to use more frequent administration of chemotherapy (daily or weekly rather than less often) and use a biologically equivalent radiation dose Gy10 .70 and/or hyperfractionation.…”

Section: Resultsmentioning

confidence: 99%

Concurrent end‐phase boost high‐dose radiation therapy for non‐small‐cell lung cancer with or without cisplatin chemotherapy*

Graham

Clark

Abell

et al. 2006

Australasian Radiology

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The aim of this study was to audit the results of a high-dose, combined-modality prospective protocol for non-small-cell lung cancer in terms of survival, disease-specific survival and toxicity. One hundred and twenty-one patients with non-small-cell lung cancer were treated with a concurrent, end-phase, boost, high-dose radiotherapy protocol with 65 Gy in 35 fractions for more than 5 weeks. Sixty-six patients received radiotherapy alone (group 1), 29 received concurrent chemoradiation (group 2) and 26 received neoadjuvant and concurrent chemotherapy (group 3). Thirty-four patients had stage I disease, six had stage II and 81 had stage III. Overall median survival was 23 months: 75% at 1 year and 23% at 5 years. Median survivals for patients with stage I and stages II and III disease were 43 and 19 months, respectively. For stages II and III patients by groups 1-3, median survivals were 18, 25 and 18 months, respectively, and 2-year survivals were 36, 52 and 38%, respectively. Toxicity was acceptable. Overall, 9% had symptomatic pneumonitis and 7% had grades 3 and 4 oesophagitis. For those who had the mediastinum included in the volume, grade > or = 3 oesophagitis occurred in 0, 11 and 22% (n = 110, P = 0.001), respectively, for treatment groups 1-3. Overall treatment-related mortality was 3%, consisting of two septic deaths, one pneumonitis and possibly one late cardiac event, all occurring in patients who had chemotherapy (7% of 55 patients). Treatment-related mortality declined over the study period. Accelerated radiotherapy was well tolerated, with only moderate increased acute toxicity when combined with concurrent platinum chemotherapy. Toxicity was enhanced by induction chemotherapy. Overall survival outcomes were excellent for this condition. Continued use of this radiotherapy schedule is recommended as the platform for assessment of other chemotherapy schedules.

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Comparison of induction chemotherapy before radiotherapy with radiotherapy only in patients with locally advanced squamous cell carcinoma of the lung

Cited by 37 publications

References 25 publications

Trends in incidence and prognosis of the histological subtypes of lung cancer in North America, Australia, New Zealand and Europe

Trends in incidence and prognosis of the histological subtypes of lung cancer in North America, Australia, New Zealand and Europe

Concurrent conventionally factionated radiotherapy and weekly docetaxel in the treatment of stage IIIb non-small-cell lung carcinoma

Concurrent end‐phase boost high‐dose radiation therapy for non‐small‐cell lung cancer with or without cisplatin chemotherapy*

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