321. Lung Cancer. 2001 May;32(2):163-71.
Sequential chemo- and radiochemotherapy with weekly paclitaxel (Taxol) and
3D-conformal radiotherapy of stage III inoperable non-small cell lung cancer.
Results of a dose escalation study.
Willner J(1), Schmidt M, Kirschner J, Lang S, Borgmeier A, Huber RM, Flentje M.
Author information:
(1)Department of Radiotherapy, University Wuerzburg, Josef-Schneider Strasse 11,
97080 Wuerzburg, Germany. willner@strahlentherapie.uni-wuerzburg.de
The purpose of this study was the determination of the maximum tolerable dose
(MTD) of weekly paclitaxel (PX) in combination with 3D-conformal radiotherapy in
non-small cell lung cancer (NSCLC) and the evaluation of side effects, patient
outcome and tumor response. Thirty-eight patients with inoperable NSCLC,
UICC-stage IIIA (n=14)/IIIB (n=24) received two cycles of induction chemotherapy
with PX/carboplatin followed by combined radiochemotherapy (60 Gy/6 weeks) with
weekly PX which was escalated in cohorts of four patients until dose limiting
toxicity (DLT) was reached. Starting level was 40 mg/m(2). 3D-conformal
radiotherapy was applied in all patients. Toxicity was determined by WHO
criteria. Patients were followed-up 3-monthly. Thirty eight patients have entered
the study, 34 patients are evaluable. DLT was esophagitis III degrees, requiring
interruption of radiotherapy and was reached at the PX 70 mg/m(2). Two
hypersensitivity reactions (50 mg/m(2)) and one leucopenia III degrees (60
mg/m(2)) were observed. Only one patient (60 mg/m(2), 50 Gy) completely aborted
treatment. The pneumonitis rate was between 21 and 36% but showed no clear
correlation with PX dose. Tumor response (PR and CR) defined by CT-scan 6 weeks
following radiotherapy was 88% (30/34). The 1- and 2-year survival rate is 73%
and 34%. We conclude that the MTD of weekly PX with 60 Gy normofractionated
radiotherapy is 60 mg/m(2). The DLT is esophagitis. Response and survival data of
this sequential/combined approach are promising. A minor increase of pulmonary
toxicity of irradiation is suspected.
PMID: 11325487 [PubMed - indexed for MEDLINE]