BEST REGIMEN FOR RADIOCHEMOTHERAPY IN LOCALLY ADVANCED NSCLC

Lung Cancer. 2012 Mar 12. [Epub ahead of print]

Randomized phase II study of concurrent cisplatin/etoposide or paclitaxel/carboplatin and thoracic radiotherapy in patients with stage III non-small cell lung cancer.

Wang L, Wu S, Ou G, Bi N, Li W, Ren H, Cao J, Liang J, Li J, Zhou Z, Lv J, Zhang X.

Source

Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

OBJECTIVE:

To evaluate the activity and safety of concurrent thoracic radiotherapy (TRT) plus weekly paclitaxel/carboplatin (PC) regimen compared with widely used cisplatin/etoposide (PE) regimen in patients with unresectable stage III non-small cell lung cancer (NSCLC).

PATIENTS AND METHODS:

Patients were randomly assigned to receive the following treatments: PE arm, cisplatin (50mg/m(2)) on days 1, 8, 29, and 36 and etoposide (50mg/m(2)) on days 1-5 and 29-33 plus 60Gy of TRT; PC arm, weekly concurrent carboplatin (AUC=2) and paclitaxel (45mg/m(2)) plus 60Gy of TRT.

RESULTS:

A total of 65 patients were randomized (PE arm, n=33; PC arm, n=32). The 3-year overall survival (OS) was significantly better in the PE arm than in the PC arm (33.1% vs. 13%, P=.04). The incidence of Grade 3/4 neutropenia was 78.1% in the PE arm and 51.5% in the PC arm (P=.05). The rate of Grade 2 or greater radiation pneumonitis was 25% in the PE arm and 48.5% in the PC arm (P=.09).

CONCLUSIONS:

Compared to PE regimen, weekly PC regimen cannot be recommended since it failed to achieve an improvement in either OS or PFS.