PARIS, France--Comparison of two sequential Radiation Therapy Oncology Group (RTOG) trials has shown that the addition of cisplatin(Drug information on cisplatin) (Platinol) and etoposide(Drug information on 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.