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

9 Citations (Scopus)

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

Fingerprint

surgery
lungs
Cisplatin
radiation therapy
Radiotherapy
cancer
Carcinoma
Lung
toxicity
Pneumonectomy
Chemoradiotherapy
vomiting
nausea
dosage
Adjuvant Radiotherapy
Induction Chemotherapy
Esophagitis
mortality
chemotherapy
schedules

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

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

In: International Journal of Radiation Oncology Biology Physics, Vol. 45, No. 3, 1999, p. 613-621.

Research output: Contribution to journalArticle

@article{fea835e60ebf405881dae2de973ad3d8,
title = "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",
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.",
keywords = "Cisplatin, Combined treatments, Lung cancer, Radiotherapy, Surgery",
author = "Bedini, {Amedeo Vittorio} and Luca Tavecchio and Alberto Gramaglia and Sergio Villa and Mauro Palazzi",
year = "1999",
doi = "10.1016/S0360-3016(99)00214-X",
language = "English",
volume = "45",
pages = "613--621",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Radiotherapy and concurrent continuous infusion of cisplatin with adjuvant surgery in nonresectable stage III lung carcinoma

T2 - Short- and long-term results of a phase II study

AU - Bedini, Amedeo Vittorio

AU - Tavecchio, Luca

AU - Gramaglia, Alberto

AU - Villa, Sergio

AU - Palazzi, Mauro

PY - 1999

Y1 - 1999

N2 - 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.

AB - 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.

KW - Cisplatin

KW - Combined treatments

KW - Lung cancer

KW - Radiotherapy

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=0032849097&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032849097&partnerID=8YFLogxK

U2 - 10.1016/S0360-3016(99)00214-X

DO - 10.1016/S0360-3016(99)00214-X

M3 - Article

C2 - 10524413

AN - SCOPUS:0032849097

VL - 45

SP - 613

EP - 621

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 3

ER -