Concomitant chemoradiotherapy with cisplatin and docetaxel followed by surgery and consolidation chemotherapy in patients with unresectable locally advanced non-small cell lung cancer

Kaya, Ali; Büyükberber, Süleyman; Benekli, Mustafa; Coşkun, Uğur; Sevinç, Alper; Akmansu, Müge; Yıldız, Ramazan; Öztürk, Bayram; Yaman, Emel; Kalender, Mehmet; Orhan, Okan; Yamaç, Deniz; Üner, Aytuğ

doi:10.1007/s12032-009-9186-z

Cited by 13 publications

(7 citation statements)

References 22 publications

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“…With the development of radiation techniques, however, renewed enthusiasm is being given to hypofractionation. In the present study, the toxicity profile of our CCRT (with standard RT) cohort paralleled other studies with similar the raputic protocols (15)(16)(17)(18). Although concurrent CHT studies have found that weekly docetaxel and cisplatin was associated with relatively low toxicity and good compliance (4), in our study toxicities were significantly worse when compared with the SCRT group.…”

Section: Discussionsupporting

confidence: 82%

Sequential Chemoradiotherapy with Accelerated Hypofractionated Radiotherapy Compared to Concurrent Chemoradiotherapy with Standard Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer

Zhu

Liang

Fan

et al. 2014

Technol Cancer Res Treat

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To compare the outcomes and treatment-related toxicities of two chemoradiotherapy schedules given to the patients with unresectable locally advanced non-small cell lung cancer (NSCLC): sequential chemotherapy with accelerated hypofractionated radiotherapy (SCRT), and concurrent chemotherapy with standard radiotherapy (CCRT), 68 patients from two prospective clinical trials were included. Thirty-four patients were treated with SCRT using an accelerated hypofractionated radiation schedule, 34 patients received CCRT with standard radiation. Between the two treatment groups there were no significant differences in terms of overall survival, progression-free survival (PFS), locoregional-PFS or distant metastasis-PFS. For the SCRT group, the median survival time and 2- and 4-year overall survival rates were 19 months, 38.2%, and 23.5%, respectively, and for the CCRT group these were 19 months, 44.1%, and 19.6%. Esophageal and constitutional toxicities were more pronounced in the CCRT group, while there was no significant difference in pulmonary toxicities. The results suggest that for unresectable stage III NSCLC, the outcomes of SCRT with accelerated hypofractionated radiotherapy and CCRT with standard radiotherapy are similar, but the toxicities associated with treatment are less in the SCRT group.

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Section: Discussionsupporting

confidence: 82%

Sequential Chemoradiotherapy with Accelerated Hypofractionated Radiotherapy Compared to Concurrent Chemoradiotherapy with Standard Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer

Zhu

Liang

Fan

et al. 2014

Technol Cancer Res Treat

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“…Similarly, high levels of grade 3 esophagitis and pneumonitis were noted in chemotherapy protocols without 3-D conformal and IFI [26,27]. However, it has also been shown that dosimetric factors such esophageal volume treated above 45–50 Gy are risk factors for developing esophagitis [28,29].…”

Section: Discussionmentioning

confidence: 99%

Cisplatin-Docetaxel Induction plus Concurrent 3-D Conformal Radiotherapy and Weekly Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer Patients: A Phase II Trial

et al. 2012

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Concurrent chemoradiotherapy (CHRT) is the standard of care for unresectable locally advanced stage III non-small cell lung cancer. However, the optimal combination remains unclear. The aim of this study was to evaluate the efficacy of 2 induction chemotherapy cycles (days 1 and 22) with docetaxel 75 mg/m² and cisplatin 75 mg/m² followed by concurrent chemotherapy (weekly docetaxel-cisplatin, 20 mg/m²) and 3-D conformal radiotherapy for 6 weeks (66 Gy/5 fractions per week/2 Gy per fraction). The primary endpoint was the response rate. Secondary objectives were toxicity, time to progression, and overall survival. Forty-four patients were included and 40 were eligible. The mean age was 60.5 years (range 40.7–72.1), and 75% had stage IIIB disease. Six patients underwent complete R0 resection including 2 pathologic complete responses after a planned intermediate evaluation. Thirty-three patients completed CHRT. The objective response rate was 65% (95% CI 50.2–79.8). Grade 3–4 hematologic and digestive toxicities were observed mainly during the induction phase. Grade 3 esophagitis (5%) was experienced during CHRT. With a median follow-up of 38.7 months, the median progression-free survival was 28.3 months (95% CI 11.0–35.0) and the median survival rate was 31.4 months. Cisplatin-docetaxel induction followed by concurrent 3-D conformal radiotherapy and weekly chemotherapy is a feasible protocol associated with a promising response rate and acceptable toxicity.

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“…However, they had higher response and survival rates, which may related with success of surgery. [32] The only difference with the study of Nakamura et al . was higher dose of cisplatin; we found higher response rate, However, our survival rate was lower.…”

Section: Discussionmentioning

confidence: 92%

“…In phase I/II studies employing docetaxel and cisplatin concomitantly with radiotherapy, median survival rate was reported as 10.5-27 months and dose limiting toxicity was determined as esophagitis with various doses and administrations. [162628–32] …”

Section: Discussionmentioning

confidence: 99%

Concomitant chemoradiotherapy with docetaxel and cisplatin followed by consolidation chemotherapy in locally advanced unresectable non-small cell lung cancer

et al. 2013

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OBJECTIVES:To evaluate treatment results and toxicities in patients who received concomitant chemoradiotherapy (CRT) followed by consolidation with docetaxel and cisplatin in locally advanced unresectable non-small cell lung cancer (NSCLC).METHODS:Ninety three patients were included in this retrospective study. The patients received 66 Gy radiotherapy and weekly 20 mg/m2 docetaxel and 20 mg/m2 cisplatin chemotherapy concomitantly. One month later than the end of CRT, consolidation chemotherapy with four cycles of docetaxel 75 mg/m2 and cisplatin 75 mg/m2 were administered at each 21 days.RESULTS:Median age of the patients was 57 (range, 30-74). Following concomitant CRT, 14 patients (15%) showed complete and 50 patients (54%) showed partial response (total response rate was 69%). The median follow-up was 13 months (range: 2-51 months). The median overall survival was 18 months (95% confidential interval [CI]: 13.8-22.1 months); local control was 15 months (95% CI: 9.3-20.6 months); progression-free survival was 9 months (95% CI: 6.5-11.4 months). Esophagitis in eight (9%) patients, neutropenia in seven (8%) patients and pneumonitis in eight (9%) patients developed as grade III-IV toxicity due to concomitant CRT.CONCLUSION:Concomitant CRT with docetaxel and cisplatin followed by docetaxel and cisplatin consolidation chemotherapy might be considered as a feasible, and well tolerated treatment modality with high response rates despite the fact that it has not a survival advantage in patients with locally advanced unresectable NSCLC.

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Concomitant chemoradiotherapy with cisplatin and docetaxel followed by surgery and consolidation chemotherapy in patients with unresectable locally advanced non-small cell lung cancer

Abstract: Preoperative concomitant chemoradiation using weekly cisplatin and docetaxel followed by surgery and consolidation chemotherapy is effective and well tolerated in patients with unresectable locally advanced NSCLC.

Cited by 13 publications

References 22 publications

Sequential Chemoradiotherapy with Accelerated Hypofractionated Radiotherapy Compared to Concurrent Chemoradiotherapy with Standard Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer

Sequential Chemoradiotherapy with Accelerated Hypofractionated Radiotherapy Compared to Concurrent Chemoradiotherapy with Standard Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer

Cisplatin-Docetaxel Induction plus Concurrent 3-D Conformal Radiotherapy and Weekly Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer Patients: A Phase II Trial

Concomitant chemoradiotherapy with docetaxel and cisplatin followed by consolidation chemotherapy in locally advanced unresectable non-small cell lung cancer

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