NEW ORLEANSIn patients with brain metastases related to
non-small-cell lung cancer, adding paclitaxel (Taxol) plus
carboplatin (Paraplatin) to standard radiotherapy may increase
overall treatment efficacy, French investigators reported at the 36th
Annual Meeting of the American Society of Clinical Oncology.
The rationale for the combined treatment is based on the use of
radiotherapy as standard treatment of brain metasta-sesalthough
it increases survival by less than 6 monthsand recent data
suggesting that chemotherapy may also be effective in this setting.
This phase II multicenter study evaluated chemotherapy followed by
radiotherapy in 46 chemonaïve patients with inoperable brain
metastases. Patients received paclitaxel 200 mg/m² over 3 hours
and carboplatin AUC 6 on day 1 every 3 weeks. Radiotherapy 30 Gy in
10 fractions to the brain was delivered to patients who did not
respond after two to four courses of chemotherapy.
Two Courses Effective
Two courses of this regimen were considered effective and of low
toxicity, reported Gilles Robinet, MD, of the Hôpital Augustin
Morvan, Brest, France. The median number of cycles per patient was
2.5, for a total of 144 during the study.
After two cycles of chemotherapy, the effect on brain metastases
included partial response in 8 patients (18%), stable disease in 15
(36%), and progressive disease in 19 (42%) (responses were
undetermined in 2 patients).
The effects on extrabrain metastases included partial responses in 10
(22%), stable disease in 21 (47%), and progressive disease in 9 (20%)
(responses were undetermined in 5 patients).
