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

Radiation Oncology

Harry JM Groen⁴  Thijo JN Hiltermann⁴  Marc JF Mertens²  Remge M Pieterman¹  Tineke EJ Renkema³  Jeroen JW Liesker⁵  John WG van Putten⁶  Ellen M Driever⁷  Edwin Blokzijl⁷  Joachim Widder⁷  Erwin M Wiegman⁷  Leon FA van Dullemen⁴  Gerald SMA Kerner⁴ 

[1] Ommelander Hospital Group, Delfzijl, The Netherlands;Wilhelmina Hospital, Assen, The Netherlands;Refaja Hospital, Stadskanaal, The Netherlands;University of Groningen and Department of Pulmonary Diseases, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, Groningen 9700 RB, The Netherlands;Scheper Hospital, Emmen, The Netherlands;Martini Hospital, Groningen, The Netherlands;University of Groningen and Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands

关键词: Concurrent chemoradiotherapy;    Radiotherapy;    Stage III NSCLC;    Gemcitabine;   

Others  :  1151594
DOI  :  10.1186/1748-717X-9-190

 received in 2014-03-22, accepted in 2014-08-16,  发布年份 2014

【 摘 要 】

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/m² 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.

【 授权许可】

   
2014 Kerner et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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