Consolidation Docetaxel After Concurrent Chemoradiotherapy in Stage IIIB Non–Small-Cell Lung Cancer: Phase II Southwest Oncology Group Study S9504
| Autor: | Kari Chansky, Bryan R. Leigh, James D. Bearden, Primo N. Lara, Kathy S. Albain, David R. Gandara, Laurie E. Gaspar, Robert B. Livingston, Howard Burris, J. Philip Kuebler, John Crowley, Paul H. Gumerlock |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Paclitaxel medicine.medical_treatment Docetaxel Disease-Free Survival Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Combined Modality Therapy Lung cancer Etoposide Aged Neoplasm Staging Aged 80 and over Chemotherapy Taxane business.industry Middle Aged medicine.disease Survival Analysis United States Radiation therapy Treatment Outcome Female Taxoids Cisplatin business Chemoradiotherapy medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 21:2004-2010 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2003.04.197 |
| Popis: | Purpose: To test the concept of taxane sequencing in combined-modality therapy, this phase II trial (S9504) evaluated consolidation docetaxel after concurrent chemoradiotherapy in patients with pathologically documented stage IIIB non–small-cell lung cancer (NSCLC). Results were compared with those of the predecessor study (S9019) with identical eligibility, staging criteria, and treatment, excepting docetaxel consolidation. Patients and Methods: Treatment consisted of cisplatin 50 mg/m2 on days 1, 8, 29, and 36, etoposide 50 mg/m2 on days 1 through 5 and 29 through 33, and concurrent thoracic radiotherapy (total dose of 61 Gy). Consolidation docetaxel started 4 to 6 weeks after chemoradiotherapy at an initial dose of 75 mg/m2. Results: Stage subsets (tumor-node-metastasis system) in 83 eligible patients were as follows: T4N0/1, 31 patients (37%); T4N2, 22 patients (27%), and T1–3N3, 30 patients (36%). Concurrent chemoradiotherapy was generally well tolerated, but two patients died from probable radiation-associated pneumonitis. Neutropenia during consolidation docetaxel was common (57% with grade 4) and most frequent during escalation to 100 mg/m2. Median progression-free survival was 16 months, median survival was 26 months, and 1-, 2-, and 3-year survival rates were 76%, 54%, and 37%, respectively. Brain metastasis was the most common site of failure. In S9019, median survival was 15 months and 1-, 2-, and 3-year survival rates were 58%, 34%, and 17%, respectively. Conclusion: Consolidation docetaxel after concurrent chemoradiotherapy in stage IIIB NSCLC is feasible and generally tolerable, and results compare favorably with the predecessor trial S9019. Nevertheless, this study remains hypothesis-generating and does not provide definitive evidence of the benefit of this approach. Phase III trials evaluating the S9504 regimen have been initiated to validate these results. |
| Databáze: | OpenAIRE |
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