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Ask the Experts Archive > Types of Cancer > Lung Cancers > General Concerns
Carbo/Taxol Weekly vs. Every 3 Weeks
Affiliation: Abramson Cancer Center of the University of Pennsylvania
Last Modified: June 25, 2006
Dear OncoLink "Ask The Experts,"
I was recently diagnosed with non-resectable Stage III-B non-small lung cancer.
My treatment to date has been 33 radiation treatments concurrent with 7 low-dose carboplatin & taxol chemotherapy treatments. There is a question as to the next course of treatment: low-dose chemo (3 weeks on--1 week off) OR high-dose chemo (once monthly), both using the same chemo drugs listed above. Is there research supporting one regimen over the other? I am trying to choose the best option for my continued treatment. Thank you for your response.
Barbara Campling, MD, Medical Oncologist at the Abramson Cancer Center of the University of Pennsylvania, responds:
Your treatment for Stage IIIB non-small cell lung cancer has been appropriate. Radiation is the most important modality of treatment for this stage of NSCLC, and the concurrent use of chemotherapy has been shown to enhance the efficacy of radiation. You have now been advised to undergo "consolidation" chemotherapy following completion of radiation.
It is not known how much benefit the "consolidation" chemotherapy adds to the "definitive" concurrent chemotherapy and radiation. Hopefully this question will be answered by ongoing clinical studies. You have been offered two choices: either "low-dose" (3 weeks on and one week off) or "high-dose" (once monthly) carboplatin and taxol.
If you are going to go ahead with consolidation chemotherapy, you should have full doses. A full dose of taxol would be 200-225 mg per meter squared given every three weeks. A full dose of carboplatin would be an AUC (area under the concentration-time curve) of 6, given every three weeks. It is also unclear how many cycles of consolidation chemotherapy are necessary. We usually give two full- dose cycles.