Concurrent gemcitabine and 3D radiotherapy in patients with stage III unresectable non-small cell lung cancer

Gerald S. M. A. Kerner*, Leon F. A. van Dullemen, Erwin M. Wiegman, Joachim Widder, Edwin Blokzijl, Ellen M. Driever, John W. G. van Putten, Jeroen J. W. Liesker, Tineke E. J. Renkema, Remge M. Pieterman, Marc J. F. Mertens, Thijo J. N. Hiltermann, H.J.M. Groen

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

10 Citaten (Scopus)
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Samenvatting

Background: Stage III unresectable non-small cell lung cancer (NSCLC) is preferably treated with concurrent schedules of chemoradiotherapy, but none is clearly superior Gemcitabine is a radiosensitizing cytotoxic drug that has been studied in phase 1 and 2 studies in this setting. The aim of this study was to describe outcome and toxicity of low-dose weekly gemcitabine combined with concurrent 3-dimensional conformal radiotherapy (3D-CRT).

Patients & methods: Treatment consisted of two cycles of a cisplatin and gemcitabine followed by weekly gemcitabine 300 mg/m(2) during 5 weeks of 3D-CRT, 60 Gy in 5 weeks (hypofractionated-accelerated). Overall survival (OS), progression-free survival (PFS), and treatment related toxicity according to Common Toxicity Criteria of Adverse Events (CTCAE) version 3.0 were assessed.

Results: Between February 2002 and August 2008, 318 patients were treated. Median age was 64 years (range 36-86); 72% were male, WHO PS 0/1/2 was 44/53/3%. Median PFS was 15.5 months (95% confidence interval [CI], 12.9-18.1) and median OS was 24.6 months (95% CI., 21.0-28.1). Main toxicity (CTCAE grade >= 3) was dysphagia (12.6%), esophagitis (9.6%), followed by radiation pneumonitis (3.0%). There were five treatment related deaths (1.6%), two due to esophagitis and three due to radiation pneumonitis.

Conclusion: Concurrent low-dose gemcitabine and 3D-CRT provides a comparable survival and toxicity profile to other available treatment schemes for unresectable stage III.

Originele taal-2English
Artikelnummer190
Aantal pagina's7
TijdschriftRadiation oncology
Volume9
DOI's
StatusPublished - 29-aug.-2014

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