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Title: Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239

Abstract

Purpose: To investigate whether high-dose thoracic radiation given twice daily during cisplatin-etoposide chemotherapy for limited small-cell lung cancer (LSCLC) improves survival, acute esophagitis, and local control rates relative to findings from Intergroup trial 0096 (47%, 27%, and 64%). Patients and Methods: Patients were accrued over a 3-year period from 22 US and Canadian institutions. Patients with LSCLC and good performance status were given thoracic radiation to 61.2 Gy over 5 weeks (daily 1.8-Gy fractions on days 1-22, then twice-daily 1.8-Gy fractions on days 23-33). Cisplatin (60 mg/m{sup 2} IV) was given on day 1 and etoposide (120 mg/m{sup 2} IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin plus etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (Common Toxicity Criteria v 2.0) and treatment-related fatalities; response (Response Evaluation Criteria in Solid Tumors); and local control. Results: Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63 years; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, the overall survival rate was 36.6% (95% confidence interval [CI] 25.6%-47.7%), and progression-free survival 19.7% (95% CImore » 11.4%-29.6%). Thirteen patients (18%) experienced severe acute esophagitis, and 2 (3%) died of treatment-related causes; 41% achieved complete response, 39% partial response, 10% stable disease, and 6% progressive disease. The local control rate was 73%. Forty-three patients (61%) received prophylactic cranial irradiation. Conclusions: The overall survival rate did not reach the projected goal; however, rates of esophagitis were lower, and local control higher, than projected. This treatment strategy is now one of three arms of a prospective trial of chemoradiation for LSCLC (Radiation Therapy Oncology Group 0538/Cancer and Leukemia Group B 30610).« less

Authors:
 [1];  [2];  [3];  [4];  [5];  [6];  [7];  [8];  [9];  [10]
  1. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  2. Radiation Therapy Oncology Group Statistical Center, Philadelphia, Pennsylvania (United States)
  3. Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (United States)
  4. Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States)
  5. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States)
  6. Department of Thoracic/Head and Neck Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  7. Thoracic Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
  8. Radiation Center, LDS Hospital, Salt Lake City, Utah (United States)
  9. Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pennsylvania (United States)
  10. Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas (United States)
Publication Date:
OSTI Identifier:
22058976
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 83; Journal Issue: 4; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; FEMALES; IRRADIATION; LEUKEMIA; LUNGS; PATIENTS; PERFORMANCE; RADIATION DOSES; RADIOTHERAPY; SURVIVAL TIME; TOXICITY

Citation Formats

Komaki, Ritsuko, Paulus, Rebecca, Ettinger, David S, Videtic, Gregory M.M., Bradley, Jeffrey D, Glisson, Bonnie S, Langer, Corey J, Sause, William T, Curran, Walter J, and Choy, Hak. Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2012.01.075.
Komaki, Ritsuko, Paulus, Rebecca, Ettinger, David S, Videtic, Gregory M.M., Bradley, Jeffrey D, Glisson, Bonnie S, Langer, Corey J, Sause, William T, Curran, Walter J, & Choy, Hak. Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239. United States. https://doi.org/10.1016/J.IJROBP.2012.01.075
Komaki, Ritsuko, Paulus, Rebecca, Ettinger, David S, Videtic, Gregory M.M., Bradley, Jeffrey D, Glisson, Bonnie S, Langer, Corey J, Sause, William T, Curran, Walter J, and Choy, Hak. 2012. "Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239". United States. https://doi.org/10.1016/J.IJROBP.2012.01.075.
@article{osti_22058976,
title = {Phase II Study of Accelerated High-Dose Radiotherapy With Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer: Radiation Therapy Oncology Group Protocol 0239},
author = {Komaki, Ritsuko and Paulus, Rebecca and Ettinger, David S and Videtic, Gregory M.M. and Bradley, Jeffrey D and Glisson, Bonnie S and Langer, Corey J and Sause, William T and Curran, Walter J and Choy, Hak},
abstractNote = {Purpose: To investigate whether high-dose thoracic radiation given twice daily during cisplatin-etoposide chemotherapy for limited small-cell lung cancer (LSCLC) improves survival, acute esophagitis, and local control rates relative to findings from Intergroup trial 0096 (47%, 27%, and 64%). Patients and Methods: Patients were accrued over a 3-year period from 22 US and Canadian institutions. Patients with LSCLC and good performance status were given thoracic radiation to 61.2 Gy over 5 weeks (daily 1.8-Gy fractions on days 1-22, then twice-daily 1.8-Gy fractions on days 23-33). Cisplatin (60 mg/m{sup 2} IV) was given on day 1 and etoposide (120 mg/m{sup 2} IV) on days 1-3 and days 22-24, followed by 2 cycles of cisplatin plus etoposide alone. Patients who achieved complete response were offered prophylactic cranial irradiation. Endpoints included overall and progression-free survival; severe esophagitis (Common Toxicity Criteria v 2.0) and treatment-related fatalities; response (Response Evaluation Criteria in Solid Tumors); and local control. Results: Seventy-two patients were accrued from June 2003 through May 2006; 71 were evaluable (median age 63 years; 52% female; 58% Zubrod 0). Median survival time was 19 months; at 2 years, the overall survival rate was 36.6% (95% confidence interval [CI] 25.6%-47.7%), and progression-free survival 19.7% (95% CI 11.4%-29.6%). Thirteen patients (18%) experienced severe acute esophagitis, and 2 (3%) died of treatment-related causes; 41% achieved complete response, 39% partial response, 10% stable disease, and 6% progressive disease. The local control rate was 73%. Forty-three patients (61%) received prophylactic cranial irradiation. Conclusions: The overall survival rate did not reach the projected goal; however, rates of esophagitis were lower, and local control higher, than projected. This treatment strategy is now one of three arms of a prospective trial of chemoradiation for LSCLC (Radiation Therapy Oncology Group 0538/Cancer and Leukemia Group B 30610).},
doi = {10.1016/J.IJROBP.2012.01.075},
url = {https://www.osti.gov/biblio/22058976}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 83,
place = {United States},
year = {Sun Jul 15 00:00:00 EDT 2012},
month = {Sun Jul 15 00:00:00 EDT 2012}
}