This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bremnes, R. M. Articles by Vilsvik, J. Search for Related Content PubMed PubMed Citation Articles by Bremnes, R. M. Articles by Vilsvik, J. Social Bookmarking                            What's this?

Multicenter Phase II Trial of Paclitaxel, Cisplatin, and Etoposide With Concurrent Radiation for Limited-Stage Small-Cell Lung Cancer

By Roy M. Bremnes, Stein Sundstrm, Jan Vilsvik, Ulf Aaseb, for the Norwegian Lung Cancer Study Group

From the Departments of Oncology and Pulmonology, University Hospital of Troms, and Departments of Oncology and Pulmonology, University Hospital of Trondheim, Trondheim, Norway.

Address reprint requests to Roy M. Bremnes, MD, Department of Oncology, University Hospital of Troms, N-9038 Troms, Norway; email: kreftrmb{at}rito.no

PURPOSE: To investigate the feasibility, efficacy, and safety of adding paclitaxel to cisplatin/etoposide chemotherapy and concurrent thoracic radiotherapy (TRT) in treatment of limited-stage small-cell lung cancer (LD-SCLC).

PATIENTS AND METHODS: Patients received five courses of chemotherapy (paclitaxel 175 mg/m² 1-hour intravenous [IV] infusion day 1; cisplatin 50 mg/m² IV day 1; etoposide 100 mg/m² IV day 1; oral etoposide 100 mg bid days 2 to 5) at 3-week intervals. TRT (42 Gy administered in 15 fractions) was administered concurrent with chemotherapy cycle 3. All patients were evaluated before starting TRT and 4 weeks after termination of chemotherapy. Patients achieving complete remission (CR) were administered prophylactic cranial irradiation.

RESULTS: Thirty-nine patients were included, and the median age was 63 years. The median follow-up was 36 months (range, 19 to 57 months). The overall response rate was 92% (CR, 81%; partial response, 11%), and the median survival was 21 months. The 1- and 2-year disease-specific survival rates were 69% and 37%, respectively. Of 29 CR patients, 83% have relapsed. Brain metastasis was as frequent as local recurrences (42%). Hematologic toxicity included grade 3 to 4 leukopenia in 74% of patients and grade 3 thrombocytopenia in 10%. One treatment-related death occurred as a result of severe neutropenia and septicemia. Hematotoxicity caused dose reductions in 31% of courses. One patient had an anaphylactic reaction during the first paclitaxel infusion. Paclitaxel-related neuropathy and myalgia were reversible. Grade 3 esophagitis was seen in five patients during and shortly after TRT.

CONCLUSION: This novel multimodal regimen is effective and well tolerated in patients with LD-SCLC. It compares favorably with previously published phase II studies.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. A. Socinski and J. A. Bogart Limited-Stage Small-Cell Lung Cancer: The Current Status of Combined-Modality Therapy J. Clin. Oncol., September 10, 2007; 25(26): 4137 - 4145. [Abstract] [Full Text] [PDF]

				D. S. Ettinger, B. A. Berkey, R. A. Abrams, J. Fontanesi, M. Machtay, P. J. Duncan, W. J. Curran Jr, B. Movsas, and R. W. Byhardt Study of Paclitaxel, Etoposide, and Cisplatin Chemotherapy Combined With Twice-Daily Thoracic Radiotherapy for Patients With Limited-Stage Small-Cell Lung Cancer: A Radiation Therapy Oncology Group 9609 Phase II Study J. Clin. Oncol., August 1, 2005; 23(22): 4991 - 4998. [Abstract] [Full Text] [PDF]

				A Price Lung cancer * 5: State of the art radiotherapy for lung cancer Thorax, May 1, 2003; 58(5): 447 - 452. [Abstract] [Full Text] [PDF]

				M. J. Edick, A. Gajjar, H. H. Mahmoud, M. E.C. van de Poll, P. L. Harrison, J. C. Panetta, G. K. Rivera, R. C. Ribeiro, J. T. Sandlund, J. M. Boyett, et al. Pharmacokinetics and Pharmacodynamics of Oral Etoposide in Children With Relapsed or Refractory Acute Lymphoblastic Leukemia J. Clin. Oncol., April 1, 2003; 21(7): 1340 - 1346. [Abstract] [Full Text] [PDF]