Induction therapy with paclitaxel and carboplatin followed by hyperfractionated radiotherapy plus weekly concurrent chemotherapy and subsequent consolidation therapy in unresectable locally advanced non-small-cell lung cancer

Enrico Cortesi, Luca Moscetti, Fabrizio Nelli, Filippo De Marinis, Ugo De Paula, Caterina Bangrazi, Maria Rita Migliorino, Vittorio Donato

Research output: Contribution to journalArticlepeer-review

Abstract

Aims and background: The purpose of this pilot study was to determine the safety and feasibility of a complete integrated approach, including induction chemotherapy with carboplatin/paclitaxel followed by accelerated hyperfractionated radiotherapy with concurrent chemotherapy, and then by consolidation chemotherapy for locally advanced stage III non-small cell lung carcinoma. Methods: Systemic doses of carboplatin AUC 6 and paclitaxel (200 mg/m2), 3 weeks out of 4, were planned as induction and consolidation chemotherapy. Weekly carboplatin AUC of 2 plus paclitaxel (50 mg/m2) were given during thoracic radiotherapy. Results: Eighteen patients were enrolled: 10 were evaluated at the end of chemoradiation and 8 received consolidation chemotherapy. On an intent-to-treat basis, 55% of patients achieved a response after induction therapy, whereas chemoradiation and consolidation therapy increased the response rate by 33% and 16%, respectively. No patient experienced grade >3 acute hematologic toxicity during systemic-dose chemotherapy. With the exception of one episode of a severe cardiac adverse event, non-hematologic toxicity was similarly tolerable. Severe acute adverse events observed during concurrent chemoradiation were mainly represented by esophagitis, resulting in interruption of the radiotherapy in 25% of patients. More notably, only one patient experienced serious non-hematologic late toxicity. Conclusions: Although the present approach seemed feasible, our data did not support any possible advantage in favor of this three-phase integrated treatment, and therefore the design will not be investigated in a subsequent phase II study.

Original languageEnglish
Pages (from-to)133-137
Number of pages5
JournalTumori
Volume93
Issue number2
Publication statusPublished - Mar 2007

Keywords

  • Carboplatin
  • Concurrent chemoradiotherapy
  • Consolidation chemotherapy
  • Hyperfractionated radiotherapy
  • Induction chemotherapy
  • Non-small-cell lung cancer
  • Paclitaxel
  • Stage III

ASJC Scopus subject areas

  • Cancer Research

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