Results of induction chemotherapy followed by three-dimensional conformal radiotherapy and con current weekly paclitaxel for stage Ⅲ non-small cell lung cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To evaluate the toxicity and efficacy of induction chemotherapy(ICT)followed by three-dimensional conformal radiotherapy(3 DCRT)plus concurrent weekly paclitaxel for inoperable non-small cell lung cancer(NSCLC). Methods Patients with stage Ⅲ NSCLC in favorable conditions were treated with 2 to 4 cycles of carboplatin(AUC=5-6,d1)combined with paclitaxel(175 mg/m2,d1),then followed by weekly paclitaxel(40 mg/m2)and concurrent 3DCRT within 3-4 weeks.The prescription dose of radiotherapy was given as high as possible while total lung V20≤31% and total dose of the spinal cord ≤50 Gy. Results ICT was well tolerated.During the concurrent chemoradiotherapy,the treatment of 4 patients was ended ahead of the schedule because of severe pulmonary and cardiac toxicitiesthe treatment of 2 patients was delayed for 7 and 12 days because of fatigue.Leucopenia(33/56)was in grade 1-2 except 1 patient in grade 3.Lymphocytopenia was severe(54/56,42 in grade 3).Three patients developed grade 3 acute radiation-induced esophagitis.and 3 developed grade 3-4 radiation-induced pneumonitis.There was one patients each who developed grade 2,3,and 4 late esophagealdamage,respectively.Nine developed grade 2 pulmonary fibrosis.The overall response rate was 69.7%.The 1-year overall survival rate was 72.3%.The 1-year local progression-free survival rate was 62.7%. Conclusions The schedule of ICT followed by weekly paclitaxel and concurrent 3DCRT can be well tolerated by most of the favorable patients with stageⅢ NSCLC.and the toxicity is tolerable. Results of this study are encouraging, though long-term results should be followed up.