1. Dose Escalation Study of Concurrent Chemoradiotherapy With the Use of Involved-field Conformal Radiotherapy and Accelerated Hyperfractionation in Combination With Cisplatin and Vinorelbine Chemotherapy for Stage III Non–small Cell Lung Cancer
- Author
-
Tomoya Kawaguchi, Kazuto Hirata, Tatsuo Kimura, Naoki Yoshimoto, Shinzoh Kudoh, Shigeki Mitsuoka, Naruo Yoshimura, Tomohiro Tamiya, Kenji Sawa, Takuhito Tada, Yoshiya Matsumoto, Tomohiro Suzumura, Masako Hosono, Tomonori Hirashima, and Hidenori Tanaka
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Maximum Tolerated Dose ,medicine.medical_treatment ,Adenocarcinoma ,Vinorelbine ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Carcinoma ,Humans ,Survival rate ,Aged ,Cisplatin ,Chemotherapy ,business.industry ,Dose fractionation ,Chemoradiotherapy ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Radiation therapy ,030104 developmental biology ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,Dose Fractionation, Radiation ,Neoplasm Recurrence, Local ,Radiotherapy, Conformal ,business ,Follow-Up Studies ,medicine.drug - Abstract
A phase I study to determine a recommended dose of thoracic radiotherapy using accelerated hyperfractionation for unresectable non-small cell lung cancer was conducted.We used chemotherapy of a cisplatin doublet and 2 dose levels of radiation with accelerated hyperfractionation. The radiation dose levels were: a total dose of 60 Gy in 40 fractions at level 1, and 66 Gy in 44 fractions at level 2. Eligible patients with unresectable stage III non-small cell lung cancer received cisplatin and vinorelbine. Radiation therapy started on day 2 of chemotherapy and was delivered twice daily for 5 days a week.Total 12 patients were enrolled, with 6 patients each at dose levels 1 and 2. Dose-limiting toxicity was noted in 2 patients at level 1; one patient had grade 3 febrile neutropenia and the other patient had grade 3 esophagitis. No dose-limiting toxicity was noted in the 6 patients at level 2. Grade 3 to 4 leukopenia, neutropenia, and anemia were noted in 11 (92%), 9 (75%), and 8 (67%) of the total 12 patients, respectively. Grade 3 anorexia and infection were noted in 2 patients (17%) at each level. Grade 3 nausea, fatigue, esophagitis, and febrile neutropenia were noted in 1 patient (8%) at each level. The response rate in the total 12 patients was 83.3%. The median progression-free survival time and the median overall survival time were 10.7 and 24.2 months, respectively.Sixty-six gray in 44 fractions is the recommended dose for the following phase II study.
- Published
- 2018
- Full Text
- View/download PDF