A phase II study of induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer
| Autor: | Roberto Bordonaro, Concetto Scuderi, Antonio Russo, Nuccio Palermo, Alessandro Pappalardo, Franco Marletta, Giuseppe Bellissima, Carmelo Giannitto Giorgio, Sergio Castorina, Carmela Di Salvo, Daniele Santini, Carlo Di Rosa |
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| Přispěvatelé: | Giorgio, CG, Pappalardo, A, Russo, A, Santini, D, Di Rosa, C, Di Salvo, C, Castorina, S, Marletta, F, Bellissima, G, Palermo, N, Scuderi, C, Bordonaro, R |
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Settore MED/06 - Oncologia Medica Locally advanced Phases of clinical research Disease-Free Survival Drug Administration Schedule Older patients Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Pharmacology (medical) Lung cancer Aged Neoplasm Staging Pharmacology business.industry Induction chemotherapy medicine.disease Combined Modality Therapy Neoadjuvant Therapy Optimal management Concurrent chemoradiotherapy non-small-cell lung cancer chemoradiotherapy Female Non small cell business |
| Popis: | The optimal management of unresectable locally advanced non-small-cell lung cancer in older patients has not been defined to date. The present phase II study was planned to evaluate the activity and safety of platinum-based induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer. Patients received two cycles of paclitaxel (175 mg/m) and carboplatin (area under the curve: 5) day 1, every 3 weeks. Chemoradiotherapy (thoracic radiation therapy) was initiated on day 42 and consisted of 1.8 Gy daily, five times per week over 5 weeks (45.0 Gy target dose) followed by 10 2.0 Gy daily fractions. Concomitant chemotherapy was weekly paclitaxel 50 mg/mq followed by weekly carboplatin at an area under the curve of 2. The eligibility for patients: age 70 or older and histologically documented untreated non-small-cell lung cancer, locally advanced, unresectable, stage III A N2 bulky or III B. Thirty consecutive patients were enrolled onto the study. The median age was 73 (range 70-76). According to the intention-to-treat analysis, 1 month after the end of combined chemoradiotherapy, we observed complete and partial responses in one and 19 of the 30 patients, respectively, for an overall response rate of 66% (95% confidence interval, 45-76%). Median progression-free survival was 8.7 months (95% confidence interval, 3.4-37.8) and median survival was 15 months (95% confidence interval, 4.2-52.1). During the treatment, 12 patients (40.0%) experienced grade 3-4 neutropenia, two patients neutropenic fever, and three patients grade 3 anaemia and grade 3 thrombocytopenia, respectively. Grade 3 oesophagitis, during concomitant radiotherapy, was observed in six patients (20.0%). No treatment-related mortality was reported. The investigated sequential approach including induction chemotherapy followed by concurrent chemoradiotherapy appears safe and seems a reasonable chance for the treatment of locally advanced non-small-cell lung cancer in the elderly population. |
| Databáze: | OpenAIRE |
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