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Japanese Journal of Clinical Oncology 30:59-64 (2000)
© 2000 Foundation for Promotion of Cancer Research

Phase II Trial of Daily Low-dose Carboplatin and Thoracic Radiotherapy in Elderly Patients with Locally Advanced Non-small Cell Lung Cancer

Shinji Atagi1, Masaaki Kawahara1, Mitsumasa Ogawara1, Kaoru Matsui2, Noriyuki Masuda2, Shinzoh Kudoh3, Shunichi Negoro4 and Kiyoyuki Furuse1,+

1Department of Internal Medicine, National Kinki Central Hospital for Chest Diseases, Osaka, 2Department of Internal Medicine, Osaka Prefectural Habikino Hospital, Osaka, 3Osaka City University, Osaka and 4Osaka City General Hospital, Osaka, Japan

Background: The purpose of this study was to investigate the feasibility of concurrent thoracic radio­therapy (TRT) and daily low-dose carboplatin (CBDCA) in elderly patients with locally advanced non-small cell lung cancer (NSCLC) and to estimate tumor response, toxicity and survival.

Methods: Forty patients were entered in a multicenter phase II study. All were patients with pathologically documented unresectable stage IIIA or IIIB or medically inoperable stage I, II NSCLC. CBDCA 30 mg/m2 was given on days 1–5 in weeks 1–4 concurrently with TRT, mainly for radiosensitization. TRT was started 1 h after CBDCA (30 min infusion) was given. TRT was given in 2 Gy/fraction/day, 5 days a week for a total of 50–60Gy.

Results: Thirty-eight patients were assessable for treatment response and toxicity. One patient had a CR and 18 patients PRs with a response rate of 50% (95% CI, 33.4–66.6%). The main toxicities were hematological toxicity. Other toxicities were grade >=2 esophagitis in one patient, grade 3 nausea/vomiting in one and grade >=3 pulmonary toxicity in two. There was one treatment-related death due to pulmonary toxicity. For stage IIIA + IIIB patients, the median survival time was 15.1 months and 1-and 2-year actuarial survival rates were 52.6 and 20.5%, respectively. For stage I + II patients, 1- and 3-year actuarial survival rates were 90.9 and 69.3%, respectively.

Conclusions: The data suggest that TRT with daily low-dose CBDCA in elderly patients is effective and feasible because of its low toxicity and survival.

+ For reprints and all correspondence: Shinji Atagi, Department of Internal Medicine, National Kinki Central Hospital for Chest Diseases, 1180 Nagasone, Sakai, Osaka 591-8555, Japan. E-mail: atagi@kinchu.hosp.go.jpAbbreviations: NSCLC, non-small cell lung cancer; TRT, thoracic radiotherapy; CBDCA, carboplatin


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