Phase 1 Study of Accelerated Hypofractionated Radiation Therapy With Concurrent Chemotherapy for Stage III Non-Small Cell Lung Cancer: CALGB 31102 (Alliance)
| Autor: | Xiaofei Wang, Everett E. Vokes, James J. Urbanic, Lydia Hodgson, Thomas E. Stinchcombe, Jeffrey A. Bogart, Lyudmila Bazhenova, Steven E. Schild, Olwen Hahn, Ravi Salgia |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Oncology Hemoptysis Cancer Research Lung Neoplasms Hypofractionated Radiation Therapy medicine.medical_treatment Carboplatin Cohort Studies chemistry.chemical_compound 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Medicine Non-Small-Cell Lung Lung 6.2 Cellular and gene therapies Cancer Radiation Lung Cancer Middle Aged Progression-Free Survival 6.5 Radiotherapy and other non-invasive therapies Other Physical Sciences Area Under Curve 6.1 Pharmaceuticals 030220 oncology & carcinogenesis Cohort Female Radiation Dose Hypofractionation Patient Safety Accelerated Radiation Therapy Cohort study medicine.medical_specialty Paclitaxel Maximum Tolerated Dose Clinical Sciences Oncology and Carcinogenesis 03 medical and health sciences Clinical Research Internal medicine Humans Radiology Nuclear Medicine and imaging Oncology & Carcinogenesis Progression-free survival Aged Pneumonitis business.industry Carcinoma Evaluation of treatments and therapeutic interventions medicine.disease Radiation Pneumonitis Consolidation Chemotherapy Radiation therapy 030104 developmental biology chemistry business |
| Zdroj: | International journal of radiation oncology, biology, physics, vol 101, iss 1 |
| ISSN: | 0360-3016 |
| Popis: | PurposeTo investigate the safety of accelerated hypofractionated radiation therapy (AHRT) with concurrent chemotherapy (CT) for inoperable stage III non-small cell lung cancer (NSCLC).Patients and methodsThe primary objectives were to define the maximally tolerable course of accelerated radiation therapy and to describe toxicities of therapy. Total radiation therapy remained at 60Gy. The number of once-daily fractions in each successive cohort was reduced as follows: cohort 1, 60Gy in 27 fractions; cohort 2, 60Gy in 24 fractions; cohort 3, 60Gy in 22 fractions; and cohort 4, 60Gy in 20 fractions. Concurrent treatment consisted of weekly carboplatin area under the curve (AUC) 2 and paclitaxel 45mg/m2. Consolidation treatment consisted of carboplatin AUC 6 and paclitaxel 200mg/m2 every weeks×2 cycles. Maximum tolerated dose: Of 6 patients/cohort, ≤2 patients experienced grade ≥3 toxicity, and ≤1 patient experienced grade ≥4 toxicity.Results22 patients were accrued; of those, 21 patients were evaluable between July 2012 and May 2014. Grade 5 toxicity occurred in 3 patients: 1 patient in cohort 2 (hemoptysis), 2 patients in cohort 3 (hemoptysis, pneumonitis). The maximum tolerated dose (MTD) was defined by cohort 2 (60Gy in 2.5Gy/fraction). Time to grade 5 toxicity was 9months, 6months, and 9months after the start of treatment. The median follow-up time was 23.0months (range, 7.6-30.6months) in living patients, the median overall survival was 19.3months (95% confidence interval [CI] 9.3-34.0months), and the median progression-free survival was 12.2months (95% CI 6.1-22.5months).ConclusionsOnly modest hypofractionation was achievable as a result of long-term toxicities. Nevertheless, the MTD of 60Gy given at 2.5Gy/fraction allows completion of RT in 20% fewer treatments than conventional therapy. Further investigation of AHRT may help to better define the therapeutic index. |
| Databáze: | OpenAIRE |
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