单位:[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China[2]Department of Radiation Oncology, China-Japan Friendship Hospital, Beijing, China[3]Department of Radiation Oncology, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA[4]Division of Hematology and Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA[5]Department of Radiation Oncology, Fujian Province Cancer Hospital, Fuzhou, China[6]Department of Radiation Oncology, Guizhou Province People’s Hospital, Guiyang, China[7]Department of Radiation Oncology, Air Force General Hospital, PLA, Beijing, China[8]Department of Radiation Oncology, Chinese PLA General Hospital, Beijing, China
Introduction: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC) but is associated with poor chest tumor control. Here, we report results of a randomized phase 3 study comparing two CCRT regimens in improving chest tumor control by low-dose paclitaxel chemoradiation for LA-NSCLC. Methods: Due to the logistics of local referral pattern, the study was designed to enroll patients with stage III LA-NSCLC who had completed 2-4 cycles of full-dose chemotherapy. One hundred thirty four were randomized to either Arm 1 [paclitaxel at 15 mg/m(2), three times per week (Monday, Wednesday, and Friday) for 6 weeks, n = 74] or Arm 2 (weekly paclitaxel at 45 mg/Fri' for 6 weeks, n = 60). Chest radiotherapy was 60-70 Gy in standard fractionation. Response rate was the primary endpoint, with recurrence-free survival (RFS) as the secondary endpoint. Results: From March 2006 to February 2013, 71 patients completed Arm 1 treatment and 59 completed Arm 2 treatment. The response rate for Arm 1 was significantly higher (83.1%) than Arm 2 (54.2%) (p=0.001). RFS was superior in Arm 1: median 14.6 vs. 9.4 months, p = 0.005, Hazard ratio (HR) 1.87 [95% confidence interval (Cl) 1.20, 2.90]. Overall survival was not significantly different: median 32.6 months in Arm 1 vs. 31.3 months in Arm 2, p = 0.91, HR 0.97 (95% Cl 0.55, 1.70). Toxicity was significantly lower in Arm 1 for Grade 3 and 4 leukopenia/neutropenia (p < 0.001). Conclusion: Pulsed low -dose paclitaxel CCRT resulted in significantly better RFS and tumor response rate, and less hematologic toxicities than weekly CCRT for LA-NSCLC.
第一作者单位:[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China[2]Department of Radiation Oncology, China-Japan Friendship Hospital, Beijing, China
共同第一作者:
通讯作者:
通讯机构:[1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China[2]Department of Radiation Oncology, China-Japan Friendship Hospital, Beijing, China
推荐引用方式(GB/T 7714):
Lin Hongmei,Chen Yuhchyau,Shi Anhui,et al.Phase 3 randomized low-Dose Paclitaxel Chemoradiotherapy Study for locally advanced non-Small Cell lung Cancer[J].FRONTIERS in ONCOLOGY.2016,6:doi:10.3389/fonc.2016.00260.
APA:
Lin, Hongmei,Chen, Yuhchyau,Shi, Anhui,Pandya, Kishan J.,Yu, Rong...&Zhu, Guangying.(2016).Phase 3 randomized low-Dose Paclitaxel Chemoradiotherapy Study for locally advanced non-Small Cell lung Cancer.FRONTIERS in ONCOLOGY,6,
MLA:
Lin, Hongmei,et al."Phase 3 randomized low-Dose Paclitaxel Chemoradiotherapy Study for locally advanced non-Small Cell lung Cancer".FRONTIERS in ONCOLOGY 6.(2016)