Division of Radiation Oncology, Saitama Cancer Center, Saitama, Japan.
Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):1791-6. doi: 10.1016/j.ijrobp.2011.03.007. Epub 2011 May 19.
To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC).
Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m(2), and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy.
The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade ≥3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade ≥3 severity were observed in 2.6% and 1.7% of patients, respectively.
The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.
评估在先前报道的 II 期研究中评估的方案的临床适用性,该方案在 III 期不可切除的非小细胞肺癌(NSCLC)患者中进行了同步放化疗后巩固化疗,每周用紫杉醇和卡铂治疗。
2000 年 1 月至 2006 年 3 月,116 例未经治疗的组织学证实的 III 期 NSCLC 患者接受了同步放化疗。放射治疗以 2Gy 的每日剂量分剂量进行,总剂量为 60Gy,同时给予多西紫杉醇 30mg/m2,卡铂在放射治疗期间和之后每 2 周进行一次,AUC 值为 3。
全组患者中位生存时间为 25.5 个月。2 年和 5 年总生存率分别为 53%和 31%。III 期疾病患者的 3 年特异性生存率为 60%,而 IIIB 期疾病患者的 3 年特异性生存率为 35%(p=0.007)。2 年和 5 年局部控制率分别为 62%和 55%。20.7%的患者出现 3 级及以上严重程度的急性血液学毒性,2.6%和 1.7%的患者分别出现 3 级及以上严重程度的放射性肺炎和食管炎。
本系列研究再次证实了先前 II 期研究中使用的方案的可行性,并取得了优异的治疗效果。