Literature DB >> 10863062

A phase II study of paclitaxel, carboplatin, and hyperfractionated radiation therapy for locally advanced inoperable non-small-cell lung cancer (a Vanderbilt Cancer Center Affiliate Network Study).

H Choy1, R F Devore, K R Hande, L L Porter, P Rosenblatt, F Yunus, L Schlabach, C Smith, Y Shyr, D H Johnson.   

Abstract

PURPOSE: We conducted a prospective phase II study to determine the response rate, toxicity, and survival rate of concurrent weekly paclitaxel, carboplatin, and hyperfractionated radiation therapy (paclitaxel/carboplatin/HFX RT) followed by 2 cycles of paclitaxel and carboplatin for locally advanced unresectable non-small cell lung cancer (NSCLC). The weekly paclitaxel and carboplatin regimen was designed to optimize the radiosensitizing properties of paclitaxel during the concurrent phase of treatment. METHODS AND MATERIALS: Forty-three patients with unresectable stage IIIA and IIIB NSCLC from the Vanderbilt Cancer Center and Affiliate Network (VCCAN) institutions were entered onto the study from June 1996 until May 1997. Weekly intravenous (IV) paclitaxel (50 mg/m(2)/l-hour) and weekly carboplatin (AUC 2) plus concurrent hyperfractionated chest RT (1.2 Gy/BID/69.6 Gy) were delivered for 6 weeks followed by 2 cycles of paclitaxel (200 mg/m(2)) and carboplatin (AUC 6).
RESULTS: Forty-two patients were evaluable for response and toxicities. Three patients achieved a complete response (7.2%) and 30 patients achieved a partial response (71.4%), for an overall response rate of 78.6% [95% C.I. (66.2%-91.0%)]. The 1- and 2-year overall and progression-free survival rates of all 43 patients were 61.6% and 35% respectively, with a median survival time of 14.3 months. The median follow-up time was 14 months. Esophagitis was the principal toxicity. Grade 3 or 4 esophagitis occurred in 11 patients (26%). There was an incidence of 7% grade 3 and 9.5% grade 4 pulmonary toxicities.
CONCLUSIONS: Weekly paclitaxel, carboplatin, plus concurrent hyperfractionated RT is a well-tolerated outpatient regimen. The response rate from this regimen is encouraging and appears to be at least equivalent to the more toxic chemoradiation trials. These findings warrant further clinical evaluation of weekly paclitaxel/carboplatin/HFX RT in a phase III study.

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Year:  2000        PMID: 10863062     DOI: 10.1016/s0360-3016(00)00420-x

Source DB:  PubMed          Journal:  Int J Radiat Oncol Biol Phys        ISSN: 0360-3016            Impact factor:   7.038


  13 in total

Review 1.  Locally advanced non-small cell lung cancer.

Authors:  E E Cohen; E E Vokes
Journal:  Curr Treat Options Oncol       Date:  2001-02

2.  A phase I study of concurrent chemotherapy (paclitaxel and carboplatin) and thoracic radiotherapy with swallowed manganese superoxide dismutase plasmid liposome protection in patients with locally advanced stage III non-small-cell lung cancer.

Authors:  Ahmad A Tarhini; Chandra P Belani; James D Luketich; Athanassios Argiris; Suresh S Ramalingam; William Gooding; Arjun Pennathur; Daniel Petro; Kevin Kane; Denny Liggitt; Tony Championsmith; Xichen Zhang; Michael W Epperly; Joel S Greenberger
Journal:  Hum Gene Ther       Date:  2011-02-02       Impact factor: 5.695

3.  MicroRNA-148b is a potential prognostic biomarker and predictor of response to radiotherapy in non-small-cell lung cancer.

Authors:  Renfeng Wang; Fan Ye; Qiang Zhen; Tieying Song; Guoliang Tan; Weiwei Chu; Yaxiao Zhang; Baolei Lv; Xiaojian Zhao; Jiabao Liu
Journal:  J Physiol Biochem       Date:  2016-04-15       Impact factor: 4.158

4.  Higher biologically effective dose of radiotherapy is associated with improved outcomes for locally advanced non-small cell lung carcinoma treated with chemoradiation: an analysis of the Radiation Therapy Oncology Group.

Authors:  Mitchell Machtay; Kyounghwa Bae; Benjamin Movsas; Rebecca Paulus; Elizabeth M Gore; Ritsuko Komaki; Kathy Albain; William T Sause; Walter J Curran
Journal:  Int J Radiat Oncol Biol Phys       Date:  2010-10-25       Impact factor: 7.038

Review 5.  Recent developments in weekly paclitaxel therapy in lung cancer.

Authors:  W Akerley
Journal:  Curr Oncol Rep       Date:  2001-03       Impact factor: 5.075

6.  Predictive factors for radiation-induced pulmonary toxicity after three-dimensional conformal chemoradiation in locally advanced non-small-cell lung cancer.

Authors:  M Moreno; J Aristu; L I Ramos; L Arbea; J M López-Picazo; M Cambeiro; R Martínez-Monge
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7.  Concurrent paclitaxel-cisplatin and twice-a-day irradiation in stage IIIA and IIIB NSCLC shows improvement in local control and survival with acceptable hematologic toxicity.

Authors:  Julianna Pisch; Tibor Moskovitz; Olga Esik; Peter Homel; Steven Keller
Journal:  Pathol Oncol Res       Date:  2003-01-06       Impact factor: 3.201

8.  Toxicity of concurrent hyperfractionated radiation therapy and chemotherapy in locally advanced (stage III) non-small cell lung cancer (NSCLC): single institution experience in 600 patients.

Authors:  Branislav Jeremić; Biljana Miličić; Slobodan Milisavljevic
Journal:  Clin Transl Oncol       Date:  2012-07-12       Impact factor: 3.405

9.  Neoadjuvant chemoradiation followed by surgery versus surgery alone for patients with adenocarcinoma or squamous cell carcinoma of the esophagus (CROSS).

Authors:  M van Heijl; J J B van Lanschot; L B Koppert; M I van Berge Henegouwen; K Muller; E W Steyerberg; H van Dekken; B P L Wijnhoven; H W Tilanus; D J Richel; O R C Busch; J F Bartelsman; C C E Koning; G J Offerhaus; A van der Gaast
Journal:  BMC Surg       Date:  2008-11-26       Impact factor: 2.102

10.  Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study.

Authors:  P Baas; J S A Belderbos; S Senan; H B Kwa; A van Bochove; H van Tinteren; J A Burgers; J P van Meerbeeck
Journal:  Br J Cancer       Date:  2006-03-13       Impact factor: 7.640

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