Multimodality treatment of stage III non-small cell lung cancer: Analysis of a phase II trial using preoperative cisplatin and gemcitabine with concurrent radiotherapy

Francesco Cellini, Pierluigi Granone, Alfredo Cesario, Rolando M. D'Angelillo, Lucio Trodella, Marzia Ciresa, Michele Fiore, Carlo Greco, Eugenio Pompeo, Tommaso Claudio Mineo, Laura Paleari, Sara Ramella

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

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.
Lingua originaleEnglish
pagine (da-a)1517-1523
Numero di pagine7
RivistaJournal of Thoracic Oncology
Volume4
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • Chemoradiotherapy
  • Gemcitabine
  • Non-small cell lung cancer
  • Neoadjuvant therapy
  • Nodal clearance
  • Locally advanced disease

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