Dose-Escalation Study of Three-Dimensional Conformal Thoracic Radiotherapy With Concurrent S-1 and Cisplatin for Inoperable Stage III Non-Small-Cell Lung Cancer

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• 作者：Hideyuki Harada¹ ; ^{h.harada@scchr.jp} ; Makoto Nishio² ; Haruyasu Murakami³ ; Fumiyoshi Ohyanagi² ; Takuyo Kozuka⁴ ; Satoshi Ishikura⁵ ; Tateaki Naito³ ; Kyoichi Kaira³ ; Toshiaki Takahashi³ ; Atsushi Horiike² ; Tetsuo Nishimura¹ ; Nobuyuki Yamamoto³
• 关键词：Chemotherapy ; Dose escalation ; Non&ndash ; small-cell lung cancer ; Radiotherapy
• 刊名：Clinical Lung Cancer
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：14
• 期：4
• 页码：440-445
• 全文大小：291 K

文摘

Purpose

To determine the recommended dose (RD) in concurrent conformal radiotherapy with S-1 and cisplatin chemotherapy for inoperable stage III non-small-cell lung cancer.

Patients and Methods

Eligible patients with inoperable stage III non-small-cell lung cancer, age ¡Ý 20 years, performance status 0-1 received 4 cycles of intravenous cisplatin (60 mg/m², day 1) and oral S-1 (80, 100, or 120 mg based on body surface area, days 1-14) repeated every 4 weeks. Radiation doses were 66, 70, and 74 Gy for arms 1, 2, and 3, respectively.

Results

A total of 24 patients were enrolled in our study, including 6 in arm 1, 6 in arm 2, and 12 in arm 3. The patients consisted of 14 men and 10 women, with a median age of 63 years (range, 44-73 years). The median follow-up was 27.3 months (range, 8.5-42.6 months) for all patients and 33.9 months (range, 15.2-42.6 months) for those still alive. Grade 3 febrile neutropenia, lung toxicities, and heart toxicities occurred in 2, 2, and 2 patients, respectively. Dose-limiting toxicity occurred in 2, none, and 1 patient in arms 1, 2, and 3, respectively. The median survival was not reached, and the 2-year survival rate was 70 % (95 % CI, 51 % -89 % ). Two-year local relapse-free survival and distant metastasis-free survival were 74 % (95 % CI, 56 % -92 % ) and 45 % (95 % CI, 25 % -65 % ), respectively.

Conclusions

High-dose radiotherapy with S-1 and cisplatin is feasible, and 74 Gy was determined as the recommended dose.