Induction chemotherapy with carboplatin/paclitaxel followed by surgery or standard radiotherapy and concurrent daily low-dose cisplatin for locally advanced non-small cell lung cancer (NSCLC)

Daniela De Candis, Simonetta Chiara Stani, Paolo Bidoli, Vittorio Amedeo Bedini, Paolo Potepan, Pierina Navarria, Stefania Aglione, Emilio Bajetta

Research output: Contribution to journalArticlepeer-review

Abstract

Five-year survival in patients with unresectable non-small-cell lung cancer (NSCLC) is less than 10%. In the present phase II study, 43 patients with locally advanced stage IIIA or selected IIIB NSCLC were given four courses of carboplatin AUC = 6 and paclitaxel 200 mg/m2 (3-hour infusion), every 3 weeks. Responsive patients, when possible, underwent surgery followed by standard radiotherapy (50 Gy) or radiotherapy (60 Gy), with concurrent cisplatin as intravenous continuous infusion of 4 mg/m2/d. Sixteen of the 42 evaluable patients achieved partial response (38%) and 3 complete response (CR) (7%) for an overall response rate of 45% (95% CI 30.1-60.2). RO resectability rate was 29%, with 21% of pathologic CRs. Three more CRs were achieved with concurrent chemoradio-therapy in responsive but unresected patients. Grade III/IV hematologic toxicity was 9%, while one perioperative death occurred. The median duration of response was 14 months (range: 3-44+); median survival was 15 months (range: 9-47+). One-year and 2-year survival rates were 51% and 22%, respectively. The median survival in the responsive resected patients was 26 months, with 2-year survival of 57%. Carboplatin/paclitaxel represents an effective and well-tolerated induction therapy, suggesting its possible role in combination with radiotherapy as neoadjuvant treatment in locally advanced NSCLC in alternative to cisplatin-based regimens.

Original languageEnglish
Pages (from-to)265-269
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume26
Issue number3
DOIs
Publication statusPublished - Jun 2003

Keywords

  • Induction chemotherapy
  • Multimodality treatment
  • Non-small-cell lung cancer (SCLC)
  • Radiation therapy
  • Stage III
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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