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Carboplatin/paclitaxel or carboplatin/vinorelbine followed by accelerated hyperfractionated conformal radiation therapy: report of a prospective phase I dose escalation trial from the Carolina Conformal Therapy Consortium.

Publication ,  Journal Article
Marks, LB; Garst, J; Socinski, MA; Sibley, G; Blackstock, AW; Herndon, JE; Zhou, S; Shafman, T; Tisch, A; Clough, R; Yu, X; Turrisi, A ...
Published in: J Clin Oncol
November 1, 2004

PURPOSE: To prospectively determine the maximum-tolerated dose of accelerated hyperfractionated conformal radiotherapy (RT; 1.6 Gy bid) for unresectable locally advanced lung cancer (IIB to IIIA/B) following induction carboplatin/paclitaxel (C/T) or carboplatin/vinorelbine (C/N). METHODS: Induction chemotherapy, C/T or C/N, was followed by escalating doses of conformally-planned RT (73.6 to 86.4 Gy in 6.4-Gy increments). Concurrent boost methods delivered 1.6 and 1.25 Gy bid to the gross and clinical target volumes, respectively. RESULTS: Between November 1997 and February 2002, 44 patients were enrolled (median age, 59 years; 59% male; stage III, 98%; median tumor size, 4 cm). Thirty-nine patients completed induction chemotherapy: 19 had a partial response, seven progressed, 15 had no response, and three were not assessable. Chemotherapy-associated toxicities were similar in the two chemotherapy groups. The incidence of grade > or = 3 RT-induced toxicity was 1/13, 2/14, and 4/12 at 73.6, 80, and 86.4 Gy, respectively, thus defining the maximum tolerated dose at approximately 80 Gy. Toxicities were in both lung and esophagus and were similar in the two chemotherapy arms. With a median followup of 34 months in the survivors, the actuarial 2-year survival was 47%, the median survival was 18 months. Fifteen patients had tumor relapse: 5 local failures in the high-dose volume, 2 regional failures outside of the high-dose volume, and 8 distant metastases. CONCLUSION: High-dose conformal twice-daily radiation therapy to approximately 80 Gy appears tolerable in well-selected patients with unresectable lung cancer following either C/T or C/N. Dose-limiting toxicities are mainly pulmonary and esophageal.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1, 2004

Volume

22

Issue

21

Start / End Page

4329 / 4340

Location

United States

Related Subject Headings

  • Vinorelbine
  • Vinblastine
  • Treatment Outcome
  • Survival Analysis
  • Radiotherapy, Conformal
  • Proportional Hazards Models
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
 

Citation

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ICMJE
MLA
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Marks, L. B., Garst, J., Socinski, M. A., Sibley, G., Blackstock, A. W., Herndon, J. E., … Carolina Conformal Therapy Consortium, . (2004). Carboplatin/paclitaxel or carboplatin/vinorelbine followed by accelerated hyperfractionated conformal radiation therapy: report of a prospective phase I dose escalation trial from the Carolina Conformal Therapy Consortium. J Clin Oncol, 22(21), 4329–4340. https://doi.org/10.1200/JCO.2004.02.165
Marks, Lawrence B., Jennifer Garst, Mark A. Socinski, Gregory Sibley, A William Blackstock, James E. Herndon, Sunmin Zhou, et al. “Carboplatin/paclitaxel or carboplatin/vinorelbine followed by accelerated hyperfractionated conformal radiation therapy: report of a prospective phase I dose escalation trial from the Carolina Conformal Therapy Consortium.J Clin Oncol 22, no. 21 (November 1, 2004): 4329–40. https://doi.org/10.1200/JCO.2004.02.165.
Marks LB, Garst J, Socinski MA, Sibley G, Blackstock AW, Herndon JE, Zhou S, Shafman T, Tisch A, Clough R, Yu X, Turrisi A, Anscher M, Crawford J, Rosenman J, Carolina Conformal Therapy Consortium. Carboplatin/paclitaxel or carboplatin/vinorelbine followed by accelerated hyperfractionated conformal radiation therapy: report of a prospective phase I dose escalation trial from the Carolina Conformal Therapy Consortium. J Clin Oncol. 2004 Nov 1;22(21):4329–4340.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

November 1, 2004

Volume

22

Issue

21

Start / End Page

4329 / 4340

Location

United States

Related Subject Headings

  • Vinorelbine
  • Vinblastine
  • Treatment Outcome
  • Survival Analysis
  • Radiotherapy, Conformal
  • Proportional Hazards Models
  • Paclitaxel
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male