Concurrent chemoradiotherapy with low dose weekly paclitaxel in the treatment of stage Ⅲ non-small-cell lung cancer / 中国癌症杂志

ABSTRACT

Background and purpose:The curative effect with radiotherapy or chemotherapy alone for the patients with unresectable stage Ⅲ non-small-cell lung cancer was poor. The 5-year survival was only 5-10 percent. Concurrent chemoradiotherapy could achieve better local control and overall survival of those patients and it had been reported that the 5-year survival was improved to 15.8 percent, but the toxicity were much more severe at the same time. We prospectively evaluated the efficacy and toxicity of concurrent chemoradiotherapy with low dose weekly paclitaxel for unresectable stage Ⅲ non-small-cell lung cancer and tried to make the regime more tolerable without the deterioration of treatment response. Methods:Forty-eight patients with unresectable stage Ⅲ non-small-cell lung cancer were randomized into low dose weekly paclitaxel group and control group.Both groups were treated by the standard fractionation schedule. All patients were irradiated 2.0 Gy/per fraction,five fractions a week,the total radiation dose was 60-64 Gy for tumor. Patients in the low dose weekly paclitaxel group received chemotherapy with 45 mg/m 2 of paclitaxel on every Monday; the patients in control group received 50 mg/m2 of cisplatin on days 2-4 and day 23-25, and 135 mg/m 2 of paclitaxel on days 1 and 22 concomitant with the radiotherapy.Results:The CR (complete response) rates of low dose weekly paclitaxel and control group were 21% and 13% respectively(P0.05).Conclusions:The patients treated by low-dose weekly paclitaxel group showed that both survival fraction and the period of local tumor control were higher than in control group. Additionally, low dose weekly paclitaxel concomitant with radiotherapy was well tolerated and were not statistically different from control group in terms of toxicities.