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F. Lee



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    P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P1.03-031 - Concurrent Chemoradiotherapy Using Advanced Radiotherapy Technologies for Inoperable Stage III Non-Small-Cell Lung Cancer (ID 1351)

      09:30 - 09:30  |  Author(s): F. Lee

      • Abstract
      • Slides

      Background:
      Concurrent chemoradiotherapy with the standard regimen of docetaxel plus cisplatin/carboplatin for inoperable stage III non-small-cell lung cancer (NSCLC) demonstrates good synergistic activity and radiosensitizing properties but toxicities are of major concerns. This phase II noncomparative trial was conducted to determine the use of newer radiotherapy technologies including IMRT planning with PET-CT to ensure dose conformity and SPECT-CT to define functional lung volume for avoidance in reducing radiation-induced toxicity and in improving treatment outcome in patients with NSCLC.

      Methods:
      Patients with locally advanced, inoperable stage III NSCLC received weekly docetaxel (20mg/m2) and cisplatin/carboplatin (20mg/m[2]) for 6 weeks with concurrent IMRT (66Gy/6.5 weeks over 33 fraction) followed by a resting period of two weeks before administration of 2 cycles of every 3 week adjuvant chemotherapy with docetaxel (35mg/m2) and cisplatin/carboplatin (35mg/m2) at Day 1 & 8.

      Results:
      A total of thirty-four patients were recruited in the study as intent-to-treat (ITT) population. Of the twenty-seven patients (as per-protocol population, PPP) evaluable for treatment response, the overall response rate was 77.8%. Median overall survival was 35.5 months (95% CI: 21.3 – 49.7 months) (Figure 1) and progression free survival was 20.8 months (95% CI: 15.3 – 26.2 months) (Figure 2). Tolerability was evaluated in the ITT population with the majority of adverse events to be predominantly grade 1 or 2. Three (8.8%) deaths occurred, two due to fulminant chest infection and one due to disease progression. Fifteen (44.1%) had emergent severe adverse events (SAE). The incidence rates of severe oesophagitis and pneumonitis were 8.8% and 5.9% respectively.Figure 1Figure 2





      Conclusion:
      Concurrent chemoradiotherapy using advanced radiotherapeutic technologies and docetaxel-cisplatin followed by adjuvant chemotherapy for inoperable stage III non-small-cell lung cancer demonstrated good response rates, overall survival and progression free survival. The treatment protocol was generally safe and well tolerated. Adverse events are less common than reported in the literature.

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