Phase II study. Concurrent chemotherapy and radiotherapy with nitroglycerin in locally advanced non-small cell lung cancer
| Autor: | David Orta, Oscar Arrieta, María Dolores de la Mata-Moya, Monika Blake, Jorge Alexander-Alatorre, Francisco Corona, Dolores Gallardo-Rincón, Jenny G. Turcott |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Vascular Endothelial Growth Factor A Oncology medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Phases of clinical research Vinblastine Vinorelbine Disease-Free Survival Nitroglycerin Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Nitric Oxide Donors Radiology Nuclear Medicine and imaging Prospective Studies Lung cancer Aged Aged 80 and over Chemotherapy business.industry Induction chemotherapy Consolidation Chemotherapy Chemoradiotherapy Induction Chemotherapy Hematology Middle Aged medicine.disease Survival Analysis Radiation therapy Anesthesia Female Cisplatin business medicine.drug |
| Zdroj: | Radiotherapy and Oncology. 111:311-315 |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2014.01.021 |
| Popis: | Background Nitroglycerin, a nitric oxide donor agent, reduces the expression of hypoxia-inducible factor-1α (HIF-1α) and could be a normalizer of the tumor microenvironment. Both factors are associated with chemo-radio-resistance. The aim of this study was to determine the safety profile and efficacy of nitroglycerin administration with chemo-radiotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods This is a phase II trial of locally advanced NSCLC patients treated with cisplatin and vinorelbine plus concurrent nitroglycerin with radiotherapy. A 25-mg NTG patch was administered to the patients for 5days (1day before and 4days after chemotherapy induction and consolidation) and all day during chemo-radiotherapy. VEGF plasmatic level was determined before and after two cycles of chemotherapy. Results Thirty-five patients were enrolled in this trial. Sixty-three percent of patients achieved an overall response after induction of chemotherapy, and 75% achieved an overall response after chemo-radiotherapy. The median progression-free survival was 13.5months (95% CI, 8.8–18.2), and the median overall survival was 26.9months (95% CI, 15.3–38.5). Reduction of VEGF level was associated with better OS. The toxicity profile related to nitroglycerin included headache (20%) and hypotension (2.9%). Conclusions The addition of nitroglycerin to induction chemotherapy and concurrent chemoradiotherapy in patients with locally advanced NSCLC has an acceptable toxicity profile and supports the possibility to add nitroglycerin to chemotherapy and radiotherapy. A randomized trial is warranted to confirm these findings. |
| Databáze: | OpenAIRE |
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