TY - JOUR
T1 - Rapidly alternating radiotherapy and high dose cisplatin chemotherapy in stage IIIB non-small cell lung cancer
T2 - Results of a phase I/II study
AU - Gandara, David R.
AU - Valone, Frank H.
AU - Perez, Edith A.
AU - Deisseroth, Albert B.
AU - Roach, Mack
AU - Ahn, David K.
AU - Phillips, Theodore
N1 - Funding Information:
Supported in part by Grants CA 2 1744, CA 350 16, CA 25827, Bristol-Meyers Company and the Veterans Administration. Accepted for publication 9 November 1990.
PY - 1991/5/1
Y1 - 1991/5/1
N2 - Alternating radiotherapy and chemotherapy increases tumor cure rates in some animal models with reduced normal tissue damage compared to sequential use of these modalities. To test this concept in non-small cell lung cancer, 23 patients with predominantly Stage IIIB disease were treated on a Northern California Oncology Group pilot study of alternating radiotherapy and high dose cisplatin. Radiotherapy consisted of 6000 cGy delivered in three separate 10-day courses of 200 cGy/fraction/day during weeks 1 and 2, 5 and 6, and 9 and 10. High dose cisplatin, 100 mg/m2 in 3% saline, was administered on weeks 3 and 4, 7 and 8, 11 and 12, and 15 and 16. The response rate in 22 eligible patients is 73% ( 16 22) with four complete responses and 12 partial responses. Feasibility of this approach is demonstrated by 20 22 patients completing radiotherapy and a median of 2.5 courses of chemotherapy administered. Median survival time is 14.2 months (range 2-40+ months). One- and 2-year survival rates are 64% ( 14 22) and 41% ( 9 22), respectively. Hematologic, renal, and radiation-related toxicities were significant but manageable. We conclude that rapid alternation of radiotherapy and a high dose intensity cisplatin regimen is feasible in Stage IIIB non-small cell lung cancer, with a high response rate and acceptable toxicity. The long-term impact on local control and survival remains unclear, although preliminary survival data are encouraging in this poor prognosis population. Further studies of this concept are warranted.
AB - Alternating radiotherapy and chemotherapy increases tumor cure rates in some animal models with reduced normal tissue damage compared to sequential use of these modalities. To test this concept in non-small cell lung cancer, 23 patients with predominantly Stage IIIB disease were treated on a Northern California Oncology Group pilot study of alternating radiotherapy and high dose cisplatin. Radiotherapy consisted of 6000 cGy delivered in three separate 10-day courses of 200 cGy/fraction/day during weeks 1 and 2, 5 and 6, and 9 and 10. High dose cisplatin, 100 mg/m2 in 3% saline, was administered on weeks 3 and 4, 7 and 8, 11 and 12, and 15 and 16. The response rate in 22 eligible patients is 73% ( 16 22) with four complete responses and 12 partial responses. Feasibility of this approach is demonstrated by 20 22 patients completing radiotherapy and a median of 2.5 courses of chemotherapy administered. Median survival time is 14.2 months (range 2-40+ months). One- and 2-year survival rates are 64% ( 14 22) and 41% ( 9 22), respectively. Hematologic, renal, and radiation-related toxicities were significant but manageable. We conclude that rapid alternation of radiotherapy and a high dose intensity cisplatin regimen is feasible in Stage IIIB non-small cell lung cancer, with a high response rate and acceptable toxicity. The long-term impact on local control and survival remains unclear, although preliminary survival data are encouraging in this poor prognosis population. Further studies of this concept are warranted.
KW - Alternating radiotherapy
KW - Cisplatin
KW - Non-small cell lung cancer
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U2 - 10.1016/0360-3016(91)90203-G
DO - 10.1016/0360-3016(91)90203-G
M3 - Article
C2 - 1850719
AN - SCOPUS:0025904671
SN - 0360-3016
VL - 20
SP - 1047
EP - 1052
JO - International journal of radiation oncology, biology, physics
JF - International journal of radiation oncology, biology, physics
IS - 5
ER -