Author of

• 11673

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  P2.09 - Poster Session 2 - Combined Modality (ID 213)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11680

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    P2.09-007 - Comparison of toxicity and outcomes of concurrent radiotherapy with carboplatin/paclitaxel and cisplatin/etoposide in stage III non-small cell lung cancer (ID 1497)

    09:30 - 09:30  |  Author(s): M.H.W. Starmans
    • Abstract

    Background
    Concurrent chemoradiotherapy (CCRT) has become the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). The comparative merits of two widely used regimens: carboplatin/paclitaxel (PC) and cisplatin/etoposide (PE), each given with concurrent radiotherapy, remain largely undefined.

    Methods
    Records for consecutive patients with stage III NSCLC treated with PC or PE and ≥60Gy chest radiotherapy between 2000-2011 were reviewed for outcomes and toxicity. Survival was estimated using the Kaplan-Meier method and Cox modeling with the Wald test. Comparison across groups was done using the student t and chi-squared tests.

    Results
    75 (PC: 44, PE: 31) patients were analyzed. PC patients were older (median 71 vs 63 years; p=0.0006). Other characteristics were comparable between groups. With PE, there was significantly increased grade ≥3 neutropenia (39% vs 14%, p=0.024) and thrombocytopenia (10% vs 0%, p=0.039). Radiation pneumonitis was more common with PC (66% vs 38%, p=0.033). Five treatment related deaths occurred (PC: 3 vs PE: 2, p=1.000). With a median follow up of 51.6 months, there were no significant differences in relapse free survival (median PC 12.0 vs PE 11.5 months, p=0.700) or overall survival (median PC 20.7 vs PE 13.7 months; p=0.989). In multivariate analyses, no factors predicted for improved survival for either regimen. Table 1: Non-hematological and hematological adverse events, by grade (CTCAE 4.0)

    Adverse events	PC (n = 44)	PE (n = 31)
    	n (%)	n	P~χ2~
    Esophagitis 1 2 3 4	3 (7) 19 (43) 10 (23) 5 (11)	5 (16) 7 (23) 10 (32) 1 (3)	0.151
    Pneumonitis 1 2 3 4 5	21 (48) 6 (14) 0 (0) 1 (2) 1 (2)	4 (13) 6 (19) 1 (3) 1 (3) 0 (0)	0.033
    Neuropathy 1 2	1 (2) 1 (2)	0 (0) 0 (0)	0.485
    Nephropathy 1 2 3	3 (7) 0 (0) 0 (0)	4 (13) 0 (0) 1 (3)	0.314
    Nausea/vomiting 1 2 3	7 (16) 8 (18) 0 (0)	7 (23) 2 (6) 1 (3)	0.291
    Chest infection 1 2 3 4 5	1 (2) 1 (2) 11 (25) 1 (2) 1 (2)	0 (0) 3 (10) 5 (16) 2 (6) 1 (3)	0.534
    Neutropenia 1 2 3 4	4 (9) 5 (11) 6 (14) 0 (0)	2 (6) 0 (0) 8 (26) 4 (13)	0.024
    Febrile neutropenia 3 4	5 (11) 0 (0)	5 (16) 1 (3)	0.394
    Anemia 1 2 3 4	12 (27) 5 (11) 1 (2) 0 (0)	10 (32) 9 (29) 0 (0) 1 (3)	0.117
    Thrombocytopenia 1 2 3	1 (2) 3 (7) 0 (0)	4(13) 1 (3) 3 (10)	0.039
    Treatment-related deaths	3 (7)	2 (6)	1.000

    Conclusion
    PC was more likely to be used in elderly patients. Despite this, PC resulted in significantly less hematological toxicity but achieved similar survival outcomes as PE. PC is an acceptable CCRT regimen, especially in older patients with multiple comorbidities.