Paclitaxel and carboplatin with simultaneous thoracic irradiation in regionally advanced non-small cell lung cancer

Chandra Belani, J. Aisner, R. Ramanathan, J. Jett, J. Greenberger, R. Day, M. J. Capazolli, D. Hiponia, C. Engstrom

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Sequential chemoradiotherapy has been used repeatedly in the treatment of patients with advanced, unresectable non-small cell lung cancer. Studies by the Cancer and Leukemia Group B, the Eastern Cooperative Oncology Group, the Radiation Therapy Oncology Group, and European investigators demonstrate superior survival results for combined-modality therapy over radiotherapy alone. Based on these results end on our previous work with carboplatin end standard daily thoracic radiotherapy, a phase II study was designed to incorporate radiosensitizing paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) doses into the carboplatin/radiotherapy regimen to improve the therapeutic index and define the toxicities. Eligible patients had histologically confirmed, regionally advanced, unresectable non-small cell lung cancer and were not allowed to have received prior chemoradiotherapy. During 6 to 7 weeks of treatment, peclitaxel 45 mg/m2/wk was administered over 3 hours before carboplatin 100 mg/m2/wk. Thoracic radiotherapy was given 5 days per week in 1.8-Gy fractions throughout the treatment period, for a total dose of 60 to 65 Gy. No grade 4 toxicities were noted among the 32 patients enrolled. Seven patients had chemotherapy doses delayed for grade 3 neutropenia, and one patient had grade 3 mucositis/esophagitis that required hospitalization. Two deaths during the study were attributed to rapidly progressive disease. Median survival has not yet been reached, and all patients are being observed for patterns of response end survival. These preliminary data demonstrate the feasibility of combined paclitaxel, carboplatin, and simultaneous thoracic irradiation with acceptable toxicities. The regimen appears promising in regionally advanced non-small cell lung cancer end should be incorporated in future randomized studies. Additionally, full-dose induction chemotherapy regimens to maximize the systemic effects followed by simultaneous chemoradiotherapy require evaluation in future studies.

Original languageEnglish (US)
JournalSeminars in Radiation Oncology
Issue number2 SUPPL. 1
StatePublished - Jun 25 1997

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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