Radiotherapy and concurrent continuous infusion of cisplatin with adjuvant surgery in nonresectable stage III lung carcinoma: Short- and long-term results of a phase II study

Amedeo Vittorio Bedini, Luca Tavecchio, Alberto Gramaglia, Sergio Villa, Mauro Palazzi

Research output: Contribution to journalArticle

Abstract

Purpose: Cisplatin-enhanced radiotherapy plus adjuvant surgery was evaluated in nonresectable non-small cell lung carcinoma (NSCLC).Methods and Materials: Doses of 50 Gy (administered in standard fractionation in 5 weeks) were delivered with concurrent cisplatin in continuous infusion (daily dose: 4 mg/m2), to 32 Stage IIIa and 45 Stage IIIb patients enrolled in a Phase II study. Patients without progression underwent surgery.Results: Esophagitis (64%), nausea/vomiting (34%), and pulmonary toxicity (14%) were the main side effects. Grade 3 toxicity occurred in 4 instances. A clinical locoregional major response was achieved by 55 patients (there were 10 complete responses). Forty patients underwent surgery, 7 with a nonradical procedure. Seven patients died due to surgery-related complications, which were significantly impacted by right pneumonectomy (71% vs. 6% of the other procedures, p <0.0001). Eighteen of the 40 surgical patients were assessed to be without viable tumor and 11 with microresidual carcinoma. There were 13 disease-free, 5-year survivors.Conclusions: Toxicity was low but activity high with the chemoradiotherapy. Adjuvant surgery increased the rate of complete responses, but right pneumonectomy had an unacceptable mortality. The role of surgery needs further refinement. Integration of the chemoradiotherapy schedule with cisplatin-based induction chemotherapy is advisable. Copyright (C) 1999 Elsevier Science Inc.

Original languageEnglish
Pages (from-to)613-621
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume45
Issue number3
DOIs
Publication statusPublished - 1999

Keywords

  • Cisplatin
  • Combined treatments
  • Lung cancer
  • Radiotherapy
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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