Print version ISSN 0378-4835
VILLANUEVA, N. et al. Weekly 70 Gy thoracic radiotheraphy concurrent with docetaxel or paclitaxel after induction chemotherapy of patients with locally advanced non-small cell lung cancer: Prospective study of tolerance and efficacy. Oncología (Barc.) [online]. 2006, vol.29, n.10, pp.30-36. ISSN 0378-4835.
INTRODUCTION: Chemotherapy (CT) and thoracic radiotherapy (TRT) constitute the standard care of patients with inoperable/unresectable locally advanced NSCLC. However, the optimal schedule of treatment remains to be determined. METHODS: A prospective study was conducted in patients with locally advanced stage IIIA or IIIB NSCLC, to determine the tolerability and local control obtained with 7 weekly courses of concurrent chemo-radiotherapy using Docetaxel (D: 20 mg/m2) or Paclitaxel (P: 60 mg/m2) and TRT (2 Gy daily Monday through Friday, totalizing 70 Gy in the seven weeks), after 3 cycles of cisplatinum-based induction chemotherapy (cisplatinum + gemcitabine +/- vinorelbine). RESULTS: From December 1999 to December 2004, fifty two out of 129 patients treated with induction chemotherapy and at least with stable disease were considered eligible for analysis. Twenty seven were treated with docetaxel (D) and twenty five with paclitaxel (P). The average of weeks of treatment was 5 for D (range 7-3) and 6 for P (7-1), and 40% and 58% of patients respectively in each group completed 7 weeks and received the programmed doses. Significant toxicity during concurrent therapy included (D/P %): esophagitis (grade I, 22/18; grade II, 25/29; grade III, 30/8), pneumonitis (grades I-II, 14/5), diarrhea (grades I-II, 14/0). The percentage of local progression and median time elapsed were 41% and 180 days in the D group of patients, and 46% and 240 days in the P group. CONCLUSION: No definitive conclusions can be made, considering the small size of the sample in this study, but the observed trends suggest that concurrent chemo-radiotherapy employing TRT and Docetaxel or Paclitaxel administered weekly offer similar local efficacy, Paclitaxel showing a lower toxicity.
Keywords : Non-small cell lung cancer (NSCLC); Chemo-radiotherapy; Taxanes.