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70 Gy Thoracic Radiotherapy (TRT) is Feasible Concurrent with Chemotherapy for Limited Stage Small Cell Lung Cancer (L-SCLC): Preliminary Analysis of a CALGB Phase II Trial
Reviewer: William Levin, MD
Last Modified: October 9, 2002
Presenter: J.A. Bogart
Presenter's Affiliation: Upstate Medical University, Syracuse, NY, USA
Type of Session: Scientific
- This study was designed to further investigate the optimal treatment regimen for L-SCLC.
- A previous randomized intergroup trial showed a survival benefit for twice-daily TRT (total 45 Gy) with chemotherapy, versus chemotherapy and once daily radiation therapy (total 45 Gy).
- The current study was designed to prospectively study the feasibility and efficacy of 70 Gy/in once-daily fractions with concurrent chemotherapy.
Materials and Methods
- 63 patients were enrolled on the study. They received 70 Gy in TRT in 2 Gy per day fractions. Patients received 2 cycles of Taxol prior to TRT. They then received 3 cycles of carboplatin/etoposide concurrently with TRT.
- Prophylactic cranial irradiation (PCI) was given to those patients with a CR or good PR to therapy.
- TRT was to the post-induction chemotherapy volume.
- Median follow-up is 18.4 months.
- Mean age was 60 years.
- 90% of patients proceeded to TRT following induction chemotherapy.
- One fatality occurred on treatment during the TRT phase.
- Non-hematologic grade 3/4 toxicities were seen in 10% of patients.
- Febrile neutropenia was seen in 16% of patients.
- No grade 4 pulmonary toxicity has been reported.
- 65% of patients experienced a CR or sustained PR (stable for 6 months or more).
- 70 Gy/once daily TRT can safely be given with concurrent chemotherapy for L-SCLC.
- Longer follow-up is necessary before drawing conclusions regarding efficacy.
- Short term analysis of this study suggests that once-daily radiation given to 70 Gy with chemotherapy may be possible, but again, follow-up is short.
- Once-daily high dose TRT treatments, if safe and effective, would need to be tested against the current standard regimen of BID irradiation in patients with excellent performance status.
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