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Chemoradiotherapy Followed by Docetaxel May Increase Life Expectancy in Non-Small-Cell Lung Cancer Patients

Chemoradiotherapy Followed by Docetaxel May Increase Life Expectancy in Non-Small-Cell Lung Cancer Patients

The administration of docetaxel (Taxotere) immediately after conventional chemotherapy with cisplatin (Platinol)/etoposide and radiotherapy results in prolonged survival in patients with stage IIIB non-small-cell lung cancer, reported researchers from the Southwest Oncology Group (SWOG) at the Ninth World Conference on Lung Cancer. Results of the phase II trial showed that 53% of patients remained alive at 2-year follow-up, which until now, was the highest reported 2-year survival rate for this cohort of patients since a previous SWOG study reported a 34% survival rate.

"Most patients with locally advanced non-small-cell lung cancer continue to die of progressive disease despite advances in combined modality treatment," said David R. Gandara, md, the study’s principal investigator, professor of medicine and director of clinical trials at the University of California Medical Center, Davis. "Our data show that the addition of docetaxel to concurrent chemotherapy and radiation therapy results in over 50% of patients remaining alive at 2 years of follow-up."

Patient Characteristics and Dosing Schedule

The 83 study participants had newly diagnosed primary bronchogenic non-small-cell lung cancer and pathologically documented stage IIIB disease that was too extensive to be surgically cured. Patients ranged from 34 to 80 years old, and their performance status ranged from 0 to 2.

All patients received cisplatin, 50 mg/m2, administered intravenously on days 1 and 8, and etoposide, 50 mg/m2, administered intravenously each day for 5 days. The chemotherapy regimen was repeated 4 weeks later. On the day chemotherapy began, radiotherapy was also initiated, and continued for 5 days a week for 5 weeks. Docetaxel, 75 to 100 mg/m2, was administered intravenously starting about 4 weeks after the completion of chemoradiotherapy, with the treatment repeating every 21 days for three cycles.

Contrasting Results

The median survival was 26 months, and the 1-year survival rate was 76%. In the earlier SWOG trial, in which two additional cycles of cisplatin/etoposide were administered after initial concurrent chemotherapy and radiotherapy, the median survival was 15 months with a 1-year survival of 58%.

Concurrent chemotherapy with radiotherapy was reasonably well tolerated. Side effects during consolidation treatment with docetaxel included neutropenia, and three patients died of pulmonary complications.

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