Dose-escalating conformal thoracic radiation therapy with induction and concurrent carboplatin/paclitaxel in unresectable stage IIIA/B nonsmall cell lung carcinoma: A modified phase I/II trial

摘要: BACKGROUND A modified Phase I/II trial was conducted evaluating the incorporation of three-dimensional conformal radiation therapy into a strategy sequential and concurrent carboplatin/paclitaxel in Stage III unresectable nonsmall cell lung carcinoma (NSCLC). The dose thoracic (TCRT) from 60 to 74 gray (Gy) increased. Endpoints included response rate, toxicity, survival. METHODS Sixty-two patients with NSCLC were included. Patients received 2 cycles induction carboplatin (area under concentration curve [AUC], 6) paclitaxel (225 mg/m2 over 3 hours) every 21 days. On Day 43, TCRT weekly (×6) (AUC, 2) (45 mg/m2/3 initiated. escalated Gy 4 cohorts (60, 66, 70, Gy). RESULTS The rate 40%. Eight (13%) progressed on phase. No dose-limiting toxicity observed during escalation Gy. major esophagitis, however, only 8% developed Grade 3/4 esophagitis using Radiation Therapy Oncology Group criteria. overall 52%. Survival rates at 1, 2, 3, years 71%, 52%, 40%, 36%, respectively, median survival 26 months. 1-, 2-, 3-year progression free probabilities 47%, 35%, 29%, respectively. CONCLUSIONS Incorporation is feasible, possible acceptable toxicity. Overall are encouraging. Both locoregional distant failure remain problematic this population patients. Cancer 2001;92:1213–23. © 2001 American Society.