Concurrent chemoradiation therapy with Docetaxel/Cisplatin followed by Docetaxel consolidation therapy in inoperable stage IIIA/B non-small-cell lung cancer

• Verfasst von: Huber, Rudolf M. [VerfasserIn]
• Verfasst von: Borgmeier, Astrid [VerfasserIn]
• Verfasst von: Flentje, Michael [VerfasserIn]
• Verfasst von: Willner, Jochen [VerfasserIn]
• Verfasst von: Schmidt, Michael [VerfasserIn]
• Verfasst von: Manegold, Christian [VerfasserIn]
• Verfasst von: Bramlage, Peter [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Titel: Concurrent chemoradiation therapy with Docetaxel/Cisplatin followed by Docetaxel consolidation therapy in inoperable stage IIIA/B non-small-cell lung cancer
• Titelzusatz: results of a phase I study
• Verf.angabe: Rudolf M. Huber, Astrid Borgmeier, Michael Flentje, Jochen Willner, Michael Schmidt, Christian Manegold, Peter Bramlage, Jürgen Debus
• E-Jahr: 2010
• Jahr: [January 2010]
• Umfang: 6 S.
• Fussnoten: Gesehen am 23.05.2023
• Titel Quelle: Enthalten in: Clinical lung cancer
• Ort Quelle: Dallas, Tex. : Cancer Information Group, 1999
• Jahr Quelle: 2010
• Band/Heft Quelle: 11(2010), 1 vom: Jan., Seite 45-50
• ISSN Quelle: 1938-0690
• DOI: doi:10.3816/CLC.2010.n.007
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Dose-limiting toxicity
• Sach-SW: Forced expiratory volume
• Sach-SW: Hemoglobin
• Sach-SW: Maximum tolerated dose
• K10plus-PPN: 1846027799

Abstract

Introduction - Docetaxel consolidation therapy (DCT) after concurrent cisplatin/docetaxel chemoradiation therapy (CRT) produces high tumor control in non-small-cell lung cancer (NSCLC); toxicity is, however, considerable. We aimed to determine the maximally tolerated dose (MTD) for DCT. - Patients and Methods - Patients with inoperable stage IIIB NSCLC received docetaxel 20 mg/m2 and cisplatin 25 mg/m2 on days 1, 8, 15, 22, 29, and 36, with concurrent radiation therapy 5 days per week for a total dose of 66 Gy. Patients achieving stable disease, partial response, or complete response were given DCT on days 71, 92, and 113. DCT was started with 75 mg/m2 and titrated depending on tolerability. The MTD of docetaxel was defined as the dose preceding that at which 3 or more patients experienced dose-limiting toxicity (DLT). - Results - Of 23 patients enrolled (median age, 58.8 years ± 7.3 years), 19 received complete CRT (4 withdrew because of toxicity). Of the patients receiving complete CRT, 1 patient died and 1 became operable, leaving 17 patients eligible for DCT starting at 75 mg/m2. After the third patient with DLT, dose was reduced to 60 mg/m2. Median survival was 27.6 months ± 23.1 months. Median TTP was 12.4 months ± 10.7 months. - Conclusion - The MTD of DCT after concurrent cisplatin/docetaxel CRT was determined to be 60 mg/m2, but toxicity was considerable. The benefit-risk ratio of DCT has, however, been questioned by a placebo-controlled phase III trial. Further phase III trials need to consider further stratification factors (pretreatment forced expiratory volume [FEV]1, hemoglobin, performance, and stage) to define a role for DCT in patients with NSCLC.