Concurrent two-dimensional radiotherapy and weekly docetaxel in the treatment of stage III non-small cell lung cancer: a good local response but no good survival due to radiation pneumonitis

Oda, Hiroshi; Kuriyama, Kinya; Yamaguchi, Motoshi; Komiyama, Takafumi; Tanaka, Shiho; Araki, Tsutomu; Nishikawa, Keiichi; Ishiguro, Hiroshi

doi:10.1016/s0169-5002(02)00532-9

Cited by 78 publications

(43 citation statements)

References 15 publications

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“…The incidence of grade 3 oesophagitis was 17% (no grade 4), which was not over the expected rate (Mauer et al, 1998). Pneumonitis was reported as the principal toxicity in a recent study of concurrent two-dimensional radiotherapy (60 -66 Gy) plus weekly docetaxel 20 mg m À2 and was considered by the authors to have adversely affected survival (Onishi et al, 2003). In the current study, treatment-related pneumonitis occurred to a similar extent with radiotherapy alone and chemoradiotherapy (one and two patients, respectively), and was fatal in one patient per arm.…”

Section: Discussionmentioning

confidence: 80%

Docetaxel-based induction therapy prior to radiotherapy with or without docetaxel for non-small-cell lung cancer

Scagliotti

Szczęsna²,

Ramlau³

et al. 2006

Br J Cancer

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This trial aimed to assess the feasibility and tumour control of concurrent chemoradiotherapy or radiotherapy alone after docetaxelbased induction chemotherapy in locally advanced non-small-cell lung cancer (NSCLC). Patients with stage IIIA/IIIB NSCLC received two 21-day cycles of induction chemotherapy with docetaxel (85 mg m À2 , day 1) plus cisplatin (40 mg m À2 , days 1 and 2). Patients without disease progression on day 43 were randomised to radiotherapy (2 Gy for 5 days week À1 ; total 60 Gy) alone or with docetaxel 20 mg m À2 once weekly every 6 weeks. Of 108 patients who received induction chemotherapy, 104 were evaluable for response. After induction chemotherapy, the overall response rate (ORR) was 44%; 91 (88%) patients had no disease progression and 89 were subsequently randomised to local treatment. After randomised therapy, the ORR was 53% (chemoradiotherapy 58%; radiotherapy 48%). Median survival and time to progression were 14.9 and 7.8 months, respectively, for chemoradiotherapy and 14.0 and 7.5 months, respectively, for radiotherapy. The most common toxicities during induction chemotherapy and randomised therapy were grades 3 -4 neutropenia and grade 3 lymphocytopenia, respectively. Docetaxel -cisplatin induction therapy followed by concurrent docetaxel and thoracic radiotherapy is a feasible treatment option, showing good clinical activity and tolerability, for locally advanced NSCLC.

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Section: Discussionmentioning

confidence: 80%

Docetaxel-based induction therapy prior to radiotherapy with or without docetaxel for non-small-cell lung cancer

Scagliotti

Szczęsna²,

Ramlau³

et al. 2006

Br J Cancer

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“…Especially in recent years, with the wide application of comprehensive therapy, an increasing attention had been paid to the inXuences of chemotherapy on RP. As it was found out by Onishi et al (2003) in their study, that for patients of stage III NSCLC, while treated with radiotherapy and combined with taxotere in chemotherapy, the morbidity of grade¸3 RP was 47%. In our results, NP regime was mainly used to patients in the chemotherapy-treated group.…”

Section: Discussionmentioning

confidence: 87%

Analysis of related factors associated with radiation pneumonitis in patients with locally advanced non-small-cell lung cancer treated with three-dimensional conformal radiotherapy

Dang

et al. 2010

J Cancer Res Clin Oncol

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“…The differentiation between pneumonia, acute respiratory distress, and radiation pneumonitis is difficult because of their similar characteristics and presentation. Concurrent administration of taxane and radiation may increase the incidence of radiation pneumonitis [27,28]. Chemoradiation trials employing a taxane-based regimen have reported increased post-operative respiratory failure [29,30].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of a phase II study of docetaxel-based multimodality chemoradiotherapy for locally advanced carcinoma of the esophagus or gastroesophageal junction

et al. 2010

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We performed a phase II trial to evaluate a docetaxel-based regimen in locoregionally advanced esophageal cancer. Untreated stage II-IVa esophageal cancer patients with performance status 0-2 were included. Tumor resectability was determined prior to initiation of study. Induction docetaxel (75 mg/m(2)) and cisplatin (75 mg/m(2)) day 1 with prophylactic filgrastim was delivered every 21 days for 3 cycles. Subsequent concomitant chemoradiotherapy (CRT) utilized weekly docetaxel (20 mg/m(2)) and concurrent radiotherapy (2 Gy/day) in resectable/resected patients (50 Gy) and in unresectable patients (66 Gy). A total of 78 patients (15 squamous cell carcinoma, 60 adenocarcinoma, 3 mixed/undifferentiated; 68 men, 10 women; median age 61 years) were accrued. The regimen was administered to 59 (76%) potentially resectable patients and 13 (17%) unresectable patients; 6 patients (8%) received the regimen post-operatively. Response rate in 66 evaluable patients following induction chemotherapy was 30%. Sixty-nine patients underwent CRT. Ten patients had disease progression during CRT. Forty-five out of 59 potentially resectable patients underwent esophagectomy after CRT, and 42 patients had complete tumor resection with negative margins. Eighteen out of 59 patients who were potentially resectable patients had pathologic complete response (pCR-31%). Grade 3/4 toxicity during induction chemotherapy included leucopenia, neutropenia, vomiting, and neuropathy. Esophagitis was the predominant toxicity during CRT. Median overall survival was 11.4 months for unresectable patients, 14.3 months for resectable patients and 10.4 months for patients who received the regimen post-operatively (log-rank P = 0.2492). Docetaxel-based CRT regimen is active and tolerable in esophageal cancer. The observed pCR in the potentially resectable group indicates good local control.

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Concurrent two-dimensional radiotherapy and weekly docetaxel in the treatment of stage III non-small cell lung cancer: a good local response but no good survival due to radiation pneumonitis

Cited by 78 publications

References 15 publications

Docetaxel-based induction therapy prior to radiotherapy with or without docetaxel for non-small-cell lung cancer

Docetaxel-based induction therapy prior to radiotherapy with or without docetaxel for non-small-cell lung cancer

Analysis of related factors associated with radiation pneumonitis in patients with locally advanced non-small-cell lung cancer treated with three-dimensional conformal radiotherapy

Long-term outcome of a phase II study of docetaxel-based multimodality chemoradiotherapy for locally advanced carcinoma of the esophagus or gastroesophageal junction

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