TY - JOUR
T1 - Multimodality treatment of stage III non-small cell lung cancer: Analysis of a phase II trial using preoperative cisplatin and gemcitabine with concurrent radiotherapy
AU - D'Angelillo, Rolando M.
AU - Trodella, Lucio
AU - Ciresa, Marzia
AU - Cellini, Francesco
AU - Fiore, Michele
AU - Greco, Carlo
AU - Pompeo, Eugenio
AU - Mineo, Tommaso Claudio
AU - Paleari, Laura
AU - Granone, Pierluigi
AU - Ramella, Sara
AU - Cesario, Alfredo
PY - 2009
Y1 - 2009
N2 - Introduction: We report the results of a phase II trial exploring the efficacy and the feasibility of combination of gemcitabine and cisplatin concurrent with radiotherapy followed by surgery in patients with stage III non-small cell lung cancer. Methods: Patients with histocytologically confirmed non-small cell lung cancer were treated with cisplatin 80 mg/sqm/wk of 1 and 4 or 20 mg/sqm/d of weeks 1 and 4 and weekly gemcitabine at 300 to 350 mg/m plus involved field radiotherapy. A 3D-conformal radiotherapy was delivered up to 50.4 Gy, with daily fractionation of 1.8 Gy. After clinical, radiologic, and pneumological reassessment, patients who reentered criteria for resectability were operated. Results: The stage at diagnosis was IIIA-N2 in 29 patients and IIIB-T4N0-2 for vascular direct infiltration for the remaining 21. Fifteen patients (30%) experienced acute grade 3 to 4 hemathological toxicity, whereas acute grade 3 esophageal toxicity was recorded in three patients (6%). One patient developed a grade 4 pulmonary toxicity (2%). Clinical response was 40 (80%) partial response, one (2%) stable disease, and nine (18%) progressive disease. Thirty-six patients (72%) underwent surgery. Final pathology showed a downstaging to stage 0 to I in 25 cases (50%). Median overall survival for all patients was 21.8 months, with a 3-year survival of 40.2%. CONCLUSIONS:: The results of this phase II trial confirm the feasibility and the efficacy of concurrent chemoradiotherapy followed by surgery. © 2009 by the International Association for the Study of Lung Cancer.
AB - Introduction: We report the results of a phase II trial exploring the efficacy and the feasibility of combination of gemcitabine and cisplatin concurrent with radiotherapy followed by surgery in patients with stage III non-small cell lung cancer. Methods: Patients with histocytologically confirmed non-small cell lung cancer were treated with cisplatin 80 mg/sqm/wk of 1 and 4 or 20 mg/sqm/d of weeks 1 and 4 and weekly gemcitabine at 300 to 350 mg/m plus involved field radiotherapy. A 3D-conformal radiotherapy was delivered up to 50.4 Gy, with daily fractionation of 1.8 Gy. After clinical, radiologic, and pneumological reassessment, patients who reentered criteria for resectability were operated. Results: The stage at diagnosis was IIIA-N2 in 29 patients and IIIB-T4N0-2 for vascular direct infiltration for the remaining 21. Fifteen patients (30%) experienced acute grade 3 to 4 hemathological toxicity, whereas acute grade 3 esophageal toxicity was recorded in three patients (6%). One patient developed a grade 4 pulmonary toxicity (2%). Clinical response was 40 (80%) partial response, one (2%) stable disease, and nine (18%) progressive disease. Thirty-six patients (72%) underwent surgery. Final pathology showed a downstaging to stage 0 to I in 25 cases (50%). Median overall survival for all patients was 21.8 months, with a 3-year survival of 40.2%. CONCLUSIONS:: The results of this phase II trial confirm the feasibility and the efficacy of concurrent chemoradiotherapy followed by surgery. © 2009 by the International Association for the Study of Lung Cancer.
KW - Chemoradiotherapy
KW - Gemcitabine
KW - Locally advanced disease
KW - Neoadjuvant therapy
KW - Nodal clearance
KW - Non-small cell lung cancer
KW - Chemoradiotherapy
KW - Gemcitabine
KW - Locally advanced disease
KW - Neoadjuvant therapy
KW - Nodal clearance
KW - Non-small cell lung cancer
UR - http://hdl.handle.net/10807/204826
U2 - 10.1097/JTO.0b013e3181b9e860
DO - 10.1097/JTO.0b013e3181b9e860
M3 - Article
SN - 1556-0864
VL - 4
SP - 1517
EP - 1523
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
ER -