A Phase I Study of Chemoradiotherapy With Use of Involved-Field Conformal Radiotherapy and Accelerated Hyperfractionation for Stage III Non-Small Cell Lung Cancer: WJTOG 3305

Journal Article · Tue May 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2011.06.1991· OSTI ID:22056352

Tada, Takuhito ^[1]; Chiba, Yasutaka ^[2]; Tsujino, Kayoko ^[3]; Fukuda, Haruyuki ^[4]; Nishimura, Yasumasa ^[5]; Kokubo, Masaki ^[6]; Negoro, Shunichi ^[7]; Kudoh, Shinzoh ^[8]; Fukuoka, Masahiro ^[9]; Nakagawa, Kazuhiko ^[10]; Nakanishi, Yoichi ^[11]

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1. Department of Radiology, Osaka City University Graduate School of Medicine, Osaka (Japan)
2. Department of Environmental Medicine and Behavioural Science, Kinki University Faculty of Medicine, Osaka-sayama (Japan)
3. Department of Radiation Oncology, Hyogo Cancer Center, Akashi (Japan)
4. Department of Radiology, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino (Japan)
5. Department of Radiation Oncology, Kinki University Faculty of Medicine, Osaka-sayama (Japan)
6. Division of Radiation Oncology, Institute of Biomedical Research and Innovation, Kobe (Japan)
7. Department of Medical Oncology, Hyogo Cancer Center, Akashi (Japan)
8. Department of Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka (Japan)
9. Department of Medical Oncology, Izumi Municipal Hospital, Izumi (Japan)
10. Department of Medical Oncology, Kinki University Faculty of Medicine, Osaka-sayama (Japan)
11. Research Institute for Disease of the Chest, Graduate School of Medical Science, Kyusyu University, Fukuoka (Japan)

Purpose: A Phase I study to determine a recommended dose of thoracic radiotherapy using accelerated hyperfractionation for unresectable non-small-cell lung cancer was conducted. Methods and Materials: Patients with unresectable Stage III non-small-cell lung cancer were treated intravenously with carboplatin (area under the concentration curve 2) and paclitaxel (40 mg/m{sup 2}) on Days 1, 8, 15, and 22 with concurrent twice-daily thoracic radiotherapy (1.5 Gy per fraction) beginning on Day 1 followed by two cycles of consolidation chemotherapy using carboplatin (area under the concentration curve 5) and paclitaxel (200 mg/m{sup 2}). Total doses were 54 Gy in 36 fractions, 60 Gy in 40 fractions, 66 Gy in 44 fractions, and 72 Gy in 48 fractions at Levels 1 to 4. The dose-limiting toxicity, defined as Grade {>=}4 esophagitis and neutropenic fever and Grade {>=}3 other nonhematologic toxicities, was monitored for 90 days. Results: Of 26 patients enrolled, 22 patients were assessable for response and toxicity. When 4 patients entered Level 4, enrollment was closed to avoid severe late toxicities. Dose-limiting toxicities occurred in 3 patients. They were Grade 3 neuropathy at Level 1 and Level 3 and Grade 3 infection at Level 1. However, the maximum tolerated dose was not reached. The median survival time was 28.6 months for all patients. Conclusions: The maximum tolerated dose was not reached, although the dose of radiation was escalated to 72 Gy in 48 fractions. However, a dose of 66 Gy in 44 fractions was adopted for this study because late toxicity data were insufficient.

• OSTI ID: 22056352
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 83; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
COMBINED THERAPY
FEVER
LUNGS
NEOPLASMS
PATIENTS
RADIATION DOSES
RADIOTHERAPY
SURVIVAL TIME
TOXICITY