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Chemo Plus RT Improves Survival in NSCLC

Chemo Plus RT Improves Survival in NSCLC

PARIS, France--Comparison of two sequential Radiation Therapy
Oncology Group (RTOG) trials has shown that the addition of cisplatin
(Platinol) and etoposide (VePesid) to hyperfractionated radiation
therapy significantly boosts survival in patients with inoperable
non-small-cell lung cancer (NSCLC), Ritsuko Komaki, MD, reported
at the American Radium Society meeting.

"Today lung cancer is the number one cancer killer of both
men and women in the United States, and a major commitment of
the RTOG is clinical trials of bronchogenic carcinoma," said
Dr. Komaki, of the University of Texas M.D. Anderson Cancer Center.

She explained that the most recent RTOG phase II NSCLC trial,
91-06, turned to concurrent platinum-based combination chemotherapy
in an effort to achieve both improved local control and elimination
of distant metastases.

An earlier randomized RTOG trial, 83-11, had established that
a total dose of 69.6 Gy, achieved by hyperfractionation in twice-daily
doses of 1.2 Gy, was superior to lower doses in decreasing local
recurrences and enhancing survival.

The 76 patients enrolled in RTOG 91-06 received two cycles of
cisplatin, 50 mg/m² IV on days 1 and 8, and etoposide, 50
mg orally twice a day on days 1 through 14, starting on the first
day of hyperfractionated radiation therapy and repeated on day
29.

To weigh the relative contributions of hyperfractionation and
chemotherapy to clinical outcome, these patients were compared
with the 203 patients who had been randomized to the total dose
of 69.6 Gy in RTOG 83-11.

Dr. Komaki pointed out that the response rates were nearly identical
in both patient groups, although concurrent cisplatin and etoposide
markedly increased the incidence of acute hematologic and nonhematologic
toxicity.

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