TY - JOUR
T1 - Phase II trial of sequential chemotherapy followed by chemoradiation, surgery, and postoperative chemotherapy for the treatment of stage IIIA/IIIB non-small-cell lung cancer
AU - Lam, Prudence
AU - Berman, Stuart
AU - Thurer, Robert
AU - Ashiku, Simon
AU - DeCamp, Malcolm
AU - Goldstein, Michael
AU - Schumer, Susan
AU - Halmos, Balazs
AU - Karp, Daniel
AU - Coute, Danielle
AU - Bergman, Mark
AU - Boyd-Sirard, Cynthia
AU - Ou, Sai Hong
AU - Muzikansky, Alona
AU - Woodard, Cally
AU - Huberman, Mark
PY - 2006/9
Y1 - 2006/9
N2 - Background: The optimal treatment of locally advanced non-small-cell lung cancer remains a challenge. Although the benefit of combined chemoradiation has been established, the optimal chemotherapy regimen, timing of full-dose chemotherapy, and how best to combine chemotherapy with radiation to maximize systemic and radiosensitizing effects remain unclear. Patients and methods: Twenty-nine patients with pathologically confirmed stage IIIA/IIIB non-small-cell lung cancer were included in a phase II trial of sequential carboplatin/paclitaxel followed by chemoradiation, surgery, and postoperative gemcitabine. Twenty-five patients (86%) completed the concurrent chemotherapy and radiation therapy phase and were eligible for surgery. At restaging, 7 patients (21%) showed disease progression. Seventeen patients (59%) went on to surgery. Few were able to tolerate full postoperative chemotherapy. Results: The 1-year overall survival rate was 61%, with a 2-year survival rate of 56%. Median overall survival was 25.2 months. Seven of the patients are alive and without recurrence at the time of this writing. Our median follow-up time was 22.2 months. Reversible grade 3/4 toxicities were fairly common, experienced in 45% of patients. Conclusion: Our results with this combined modality approach are comparable with those of previous, similar studies. Postoperative chemotherapy after initial combined modality therapy is often not feasible, reinforcing the value of initial systemic therapy. Long-term results are still suboptimal and await studies adding targeted therapies to our usual chemotherapy/radiation approaches.
AB - Background: The optimal treatment of locally advanced non-small-cell lung cancer remains a challenge. Although the benefit of combined chemoradiation has been established, the optimal chemotherapy regimen, timing of full-dose chemotherapy, and how best to combine chemotherapy with radiation to maximize systemic and radiosensitizing effects remain unclear. Patients and methods: Twenty-nine patients with pathologically confirmed stage IIIA/IIIB non-small-cell lung cancer were included in a phase II trial of sequential carboplatin/paclitaxel followed by chemoradiation, surgery, and postoperative gemcitabine. Twenty-five patients (86%) completed the concurrent chemotherapy and radiation therapy phase and were eligible for surgery. At restaging, 7 patients (21%) showed disease progression. Seventeen patients (59%) went on to surgery. Few were able to tolerate full postoperative chemotherapy. Results: The 1-year overall survival rate was 61%, with a 2-year survival rate of 56%. Median overall survival was 25.2 months. Seven of the patients are alive and without recurrence at the time of this writing. Our median follow-up time was 22.2 months. Reversible grade 3/4 toxicities were fairly common, experienced in 45% of patients. Conclusion: Our results with this combined modality approach are comparable with those of previous, similar studies. Postoperative chemotherapy after initial combined modality therapy is often not feasible, reinforcing the value of initial systemic therapy. Long-term results are still suboptimal and await studies adding targeted therapies to our usual chemotherapy/radiation approaches.
KW - Mediastinal staging
KW - Multimodality therapy
KW - Radiosensitizing
KW - Timing of administration
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U2 - 10.3816/CLC.2006.n.040
DO - 10.3816/CLC.2006.n.040
M3 - Article
C2 - 17026813
AN - SCOPUS:33750188578
SN - 1525-7304
VL - 8
SP - 122
EP - 129
JO - Clinical lung cancer
JF - Clinical lung cancer
IS - 2
ER -