Phase I/II study of docetaxel and cisplatin with concurrent thoracic radiation therapy for locally advanced non-small-cell lung cancer

Katsuyuki Kiura, H. Ueoka, Y. Segawa, Masahiro Tabata, H. Kamei, N. Takigawa, S. Hiraki, Y. Watanabe, A. Bessho, K. Eguchi, N. Okimoto, S. Harita, M. Takemoto, Y. Hiraki, M. Harada, M. Tanimoto

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Abstract

Recent studies have suggested the superiority of concomitant over sequential administration of chemotherapy and radiotherapy. Docetaxel and cisplatin have demonstrated efficacy in advanced non-small-cell lung cancer (NSCLC). This study evaluated the safety, toxicity, and antitumour activity of docetaxel/cisplatin with concurrent thoracic radiotherapy for patients with locally advanced NSCLC. Patients with locally advanced NSCLC (stage IIIA or IIIB), good performance status, age ≤75 years, and adequate organ function were eligible. Both docetaxel and cisplatin were given on days 1, 8, 29, and 36. Doses of docetaxel/cisplatin (mg m-2) in the phase I study portion were escalated as follows: 20/30, 25/30, 30/30, 30/35, 30/40, 35/40, 40/40, and 45/40. Beginning on day 1 of chemotherapy, thoracic radiotherapy was given at a total dose of 60 Gy with 2 Gy per fraction over 6 weeks. In the phase I portion, the maximum tolerated doses (MTD) among 33 patients were docetaxel 45 mg m -2 and cisplatin 40 mg m-2. The major dose-limiting toxicity (DLT) was radiation oesophagitis. The recommended doses (RDs) for the phase II study were docetaxel 40 mg m-2 and cisplatin 40 mg m -2. A total of 42 patients were entered in the phase II portion. Common toxicities were leukopenia, granulocytopenia, anaemia, and radiation oesophagitis, with frequencies of grade ≥ 3 toxicities of 71, 60, 24, and 19%, respectively. Toxicity was significant, but manageable according to the dose and schedule modifications. Dose intensities of docetaxel and cisplatin were 86 and 87%, respectively. Radiotherapy was completed without a delay in 67% of 42 patients. The overall response rate was 79% (95% confidence interval (CI), 66-91%). The median survival time was 23.4 + months with an overall survival rate of 76% at 1 year and 54% at 2 years. In conclusion, chemotherapy with cisplatin plus docetaxel given on days 1, 8, 29, and 36 and concurrent thoracic radiotherapy is efficacious and tolerated in patients with locally advanced NSCLC and should be evaluated in a phase III study.

Original languageEnglish
Pages (from-to)795-802
Number of pages8
JournalBritish Journal of Cancer
Volume89
Issue number5
DOIs
Publication statusPublished - Sep 1 2003

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docetaxel
Non-Small Cell Lung Carcinoma
Cisplatin
Radiotherapy
Thorax
Esophagitis
Drug Therapy
Radiation
Agranulocytosis
Maximum Tolerated Dose
Leukopenia

Keywords

  • Cisplatin
  • Combination chemotherapy
  • Concurrent chemoradiation
  • Docetaxel
  • Lung cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Phase I/II study of docetaxel and cisplatin with concurrent thoracic radiation therapy for locally advanced non-small-cell lung cancer. / Kiura, Katsuyuki; Ueoka, H.; Segawa, Y.; Tabata, Masahiro; Kamei, H.; Takigawa, N.; Hiraki, S.; Watanabe, Y.; Bessho, A.; Eguchi, K.; Okimoto, N.; Harita, S.; Takemoto, M.; Hiraki, Y.; Harada, M.; Tanimoto, M.

In: British Journal of Cancer, Vol. 89, No. 5, 01.09.2003, p. 795-802.

Research output: Contribution to journalArticle

Kiura, K, Ueoka, H, Segawa, Y, Tabata, M, Kamei, H, Takigawa, N, Hiraki, S, Watanabe, Y, Bessho, A, Eguchi, K, Okimoto, N, Harita, S, Takemoto, M, Hiraki, Y, Harada, M & Tanimoto, M 2003, 'Phase I/II study of docetaxel and cisplatin with concurrent thoracic radiation therapy for locally advanced non-small-cell lung cancer', British Journal of Cancer, vol. 89, no. 5, pp. 795-802. https://doi.org/10.1038/sj.bjc.6601217
Kiura, Katsuyuki ; Ueoka, H. ; Segawa, Y. ; Tabata, Masahiro ; Kamei, H. ; Takigawa, N. ; Hiraki, S. ; Watanabe, Y. ; Bessho, A. ; Eguchi, K. ; Okimoto, N. ; Harita, S. ; Takemoto, M. ; Hiraki, Y. ; Harada, M. ; Tanimoto, M. / Phase I/II study of docetaxel and cisplatin with concurrent thoracic radiation therapy for locally advanced non-small-cell lung cancer. In: British Journal of Cancer. 2003 ; Vol. 89, No. 5. pp. 795-802.
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N2 - Recent studies have suggested the superiority of concomitant over sequential administration of chemotherapy and radiotherapy. Docetaxel and cisplatin have demonstrated efficacy in advanced non-small-cell lung cancer (NSCLC). This study evaluated the safety, toxicity, and antitumour activity of docetaxel/cisplatin with concurrent thoracic radiotherapy for patients with locally advanced NSCLC. Patients with locally advanced NSCLC (stage IIIA or IIIB), good performance status, age ≤75 years, and adequate organ function were eligible. Both docetaxel and cisplatin were given on days 1, 8, 29, and 36. Doses of docetaxel/cisplatin (mg m-2) in the phase I study portion were escalated as follows: 20/30, 25/30, 30/30, 30/35, 30/40, 35/40, 40/40, and 45/40. Beginning on day 1 of chemotherapy, thoracic radiotherapy was given at a total dose of 60 Gy with 2 Gy per fraction over 6 weeks. In the phase I portion, the maximum tolerated doses (MTD) among 33 patients were docetaxel 45 mg m -2 and cisplatin 40 mg m-2. The major dose-limiting toxicity (DLT) was radiation oesophagitis. The recommended doses (RDs) for the phase II study were docetaxel 40 mg m-2 and cisplatin 40 mg m -2. A total of 42 patients were entered in the phase II portion. Common toxicities were leukopenia, granulocytopenia, anaemia, and radiation oesophagitis, with frequencies of grade ≥ 3 toxicities of 71, 60, 24, and 19%, respectively. Toxicity was significant, but manageable according to the dose and schedule modifications. Dose intensities of docetaxel and cisplatin were 86 and 87%, respectively. Radiotherapy was completed without a delay in 67% of 42 patients. The overall response rate was 79% (95% confidence interval (CI), 66-91%). The median survival time was 23.4 + months with an overall survival rate of 76% at 1 year and 54% at 2 years. In conclusion, chemotherapy with cisplatin plus docetaxel given on days 1, 8, 29, and 36 and concurrent thoracic radiotherapy is efficacious and tolerated in patients with locally advanced NSCLC and should be evaluated in a phase III study.

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