Induction chemoradiotherapy using docetaxel and cisplatin with definitive-dose radiation followed by surgery for locally advanced non-small cell lung cancer

Hidejiro Torigoe, Junichi Sou, Shuta Tomida, Kei Namba, Hiroki Sato, Kuniaki Katsui, Katsuyuki Hotta, Kazuhiko Shien, Hiromasa Yamamoto, Masaomi Yamane, Susumu Kanazawa, Katsuyuki Kiura, Shinichiro Miyoshi, Shinichi Toyooka

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Abstract

Background: Induction chemoradiotherapy (CRT) followed by surgery is a therapeutic option for locally advanced non-small cell lung cancer (LA-NSCLC). Typically, around 40-50 Gy of radiation is applied as the induction-dose; however, a definitive-dose (DD) of radiation (60 Gy or higher) is occasionally applied to increase local control. We investigated the impact of induction CRT with DD radiation in LA-NSCLC patients treated with a single regimen of docetaxel and cisplatin. Methods: We reviewed 110 patients with LA-NSCLC who underwent induction CRT followed by surgery using a single regimen (docetaxel and cisplatin) between January 1999 and December 2014 at our hospital. The clinical outcomes of a DD group (60 Gy or higher, n=11) and a non-DD group (less than 60 Gy, n=99) were investigated using a propensity score (PS)-matched analysis. Results: An advanced clinical stage was significantly more common in the DD group than in the non- DD group (P=0.033). Before and after the PS-matching based on seven factors including clinical stage, there was no significant difference in the rates of postoperative (PO) complication, mortality, 5-year overall survival (OS), or 5-year recurrence-free survival (RFS) between the two groups. After the PS-matching, the pathological complete response (CR) rate was significantly higher in the DD group than in the non-DD group [50% (n=5/10) vs. 0% (n=0/10), P=0.033]. Conclusions: Induction CRT followed by surgery using docetaxel and cisplatin with DD radiation can be performed safely and is associated with a higher pathological CR rate than that attained using non-DD radiation in LA-NSCLC patients.

Original languageEnglish
Pages (from-to)3076-3086
Number of pages11
JournalJournal of Thoracic Disease
Volume9
Issue number9
DOIs
Publication statusPublished - Sep 1 2017

Fingerprint

docetaxel
Chemoradiotherapy
Non-Small Cell Lung Carcinoma
Propensity Score
Cisplatin
Radiation
Radiation Dosage
Survival
Recurrence
Mortality

Keywords

  • Definitive-dose radiation (DD radiation)
  • Induction chemoradiotherapy (induction CRT)
  • Non-small cell lung cancer (NSCLC)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{3f943f9286b54de9974a9b4c95081c23,
title = "Induction chemoradiotherapy using docetaxel and cisplatin with definitive-dose radiation followed by surgery for locally advanced non-small cell lung cancer",
abstract = "Background: Induction chemoradiotherapy (CRT) followed by surgery is a therapeutic option for locally advanced non-small cell lung cancer (LA-NSCLC). Typically, around 40-50 Gy of radiation is applied as the induction-dose; however, a definitive-dose (DD) of radiation (60 Gy or higher) is occasionally applied to increase local control. We investigated the impact of induction CRT with DD radiation in LA-NSCLC patients treated with a single regimen of docetaxel and cisplatin. Methods: We reviewed 110 patients with LA-NSCLC who underwent induction CRT followed by surgery using a single regimen (docetaxel and cisplatin) between January 1999 and December 2014 at our hospital. The clinical outcomes of a DD group (60 Gy or higher, n=11) and a non-DD group (less than 60 Gy, n=99) were investigated using a propensity score (PS)-matched analysis. Results: An advanced clinical stage was significantly more common in the DD group than in the non- DD group (P=0.033). Before and after the PS-matching based on seven factors including clinical stage, there was no significant difference in the rates of postoperative (PO) complication, mortality, 5-year overall survival (OS), or 5-year recurrence-free survival (RFS) between the two groups. After the PS-matching, the pathological complete response (CR) rate was significantly higher in the DD group than in the non-DD group [50{\%} (n=5/10) vs. 0{\%} (n=0/10), P=0.033]. Conclusions: Induction CRT followed by surgery using docetaxel and cisplatin with DD radiation can be performed safely and is associated with a higher pathological CR rate than that attained using non-DD radiation in LA-NSCLC patients.",
keywords = "Definitive-dose radiation (DD radiation), Induction chemoradiotherapy (induction CRT), Non-small cell lung cancer (NSCLC)",
author = "Hidejiro Torigoe and Junichi Sou and Shuta Tomida and Kei Namba and Hiroki Sato and Kuniaki Katsui and Katsuyuki Hotta and Kazuhiko Shien and Hiromasa Yamamoto and Masaomi Yamane and Susumu Kanazawa and Katsuyuki Kiura and Shinichiro Miyoshi and Shinichi Toyooka",
year = "2017",
month = "9",
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doi = "10.21037/jtd.2017.08.87",
language = "English",
volume = "9",
pages = "3076--3086",
journal = "Journal of Thoracic Disease",
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TY - JOUR

T1 - Induction chemoradiotherapy using docetaxel and cisplatin with definitive-dose radiation followed by surgery for locally advanced non-small cell lung cancer

AU - Torigoe, Hidejiro

AU - Sou, Junichi

AU - Tomida, Shuta

AU - Namba, Kei

AU - Sato, Hiroki

AU - Katsui, Kuniaki

AU - Hotta, Katsuyuki

AU - Shien, Kazuhiko

AU - Yamamoto, Hiromasa

AU - Yamane, Masaomi

AU - Kanazawa, Susumu

AU - Kiura, Katsuyuki

AU - Miyoshi, Shinichiro

AU - Toyooka, Shinichi

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Background: Induction chemoradiotherapy (CRT) followed by surgery is a therapeutic option for locally advanced non-small cell lung cancer (LA-NSCLC). Typically, around 40-50 Gy of radiation is applied as the induction-dose; however, a definitive-dose (DD) of radiation (60 Gy or higher) is occasionally applied to increase local control. We investigated the impact of induction CRT with DD radiation in LA-NSCLC patients treated with a single regimen of docetaxel and cisplatin. Methods: We reviewed 110 patients with LA-NSCLC who underwent induction CRT followed by surgery using a single regimen (docetaxel and cisplatin) between January 1999 and December 2014 at our hospital. The clinical outcomes of a DD group (60 Gy or higher, n=11) and a non-DD group (less than 60 Gy, n=99) were investigated using a propensity score (PS)-matched analysis. Results: An advanced clinical stage was significantly more common in the DD group than in the non- DD group (P=0.033). Before and after the PS-matching based on seven factors including clinical stage, there was no significant difference in the rates of postoperative (PO) complication, mortality, 5-year overall survival (OS), or 5-year recurrence-free survival (RFS) between the two groups. After the PS-matching, the pathological complete response (CR) rate was significantly higher in the DD group than in the non-DD group [50% (n=5/10) vs. 0% (n=0/10), P=0.033]. Conclusions: Induction CRT followed by surgery using docetaxel and cisplatin with DD radiation can be performed safely and is associated with a higher pathological CR rate than that attained using non-DD radiation in LA-NSCLC patients.

AB - Background: Induction chemoradiotherapy (CRT) followed by surgery is a therapeutic option for locally advanced non-small cell lung cancer (LA-NSCLC). Typically, around 40-50 Gy of radiation is applied as the induction-dose; however, a definitive-dose (DD) of radiation (60 Gy or higher) is occasionally applied to increase local control. We investigated the impact of induction CRT with DD radiation in LA-NSCLC patients treated with a single regimen of docetaxel and cisplatin. Methods: We reviewed 110 patients with LA-NSCLC who underwent induction CRT followed by surgery using a single regimen (docetaxel and cisplatin) between January 1999 and December 2014 at our hospital. The clinical outcomes of a DD group (60 Gy or higher, n=11) and a non-DD group (less than 60 Gy, n=99) were investigated using a propensity score (PS)-matched analysis. Results: An advanced clinical stage was significantly more common in the DD group than in the non- DD group (P=0.033). Before and after the PS-matching based on seven factors including clinical stage, there was no significant difference in the rates of postoperative (PO) complication, mortality, 5-year overall survival (OS), or 5-year recurrence-free survival (RFS) between the two groups. After the PS-matching, the pathological complete response (CR) rate was significantly higher in the DD group than in the non-DD group [50% (n=5/10) vs. 0% (n=0/10), P=0.033]. Conclusions: Induction CRT followed by surgery using docetaxel and cisplatin with DD radiation can be performed safely and is associated with a higher pathological CR rate than that attained using non-DD radiation in LA-NSCLC patients.

KW - Definitive-dose radiation (DD radiation)

KW - Induction chemoradiotherapy (induction CRT)

KW - Non-small cell lung cancer (NSCLC)

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