Lung Cancer
Volume 62, Issue 1 , Pages 62-71 , October 2008

Induction chemotherapy with cisplatin and gemcitabine followed by concurrent chemoradiation with twice-weekly gemcitabine in unresectable stage III non-small cell lung cancer: Final results of a phase II study

  • Remei Blanco

      Affiliations

    • Oncology Service, Consorci Sanitari de Terrassa, Ctra. de Torrebonica sn, 08227 Terrassa, Spain
    • Corresponding Author InformationCorresponding author. Tel.: +34 937003612; fax: +34 937003622.
    • ,
  • Josep Solé

      Affiliations

    • Radiation Oncology Service, Hospital Duran i Reynals, AV Granvia de l’Hospitalet sn, Km 2.7, 08908 L’Hospitalet de Llobregat, Spain
    • Tel.: +34 933357011; fax: +34 932607725.
    • ,
  • Jesús Montesinos

      Affiliations

    • Oncology Service, Consorci Hospitalari Parc Taulí, Parc Taulí s/n, 08208 Sabadell, Spain
    • Tel.: +34 937231010; fax: +34 937160646.
    • ,
  • Carlos Mesía

      Affiliations

    • Oncology Service, Hospital Duran i Reynals, AV Granvia de l’Hospitalet sn, Km 2.7, 08908 L’Hospitalet de Llobregat, Spain
    • Tel.: +34 933357011; fax: +34 932607725.
    • ,
  • Manuel Algara

      Affiliations

    • Radiation Oncology Service, Hospital de L’Esperança, C/Sant Josep de la Muntanya 12, 08024 Barcelona, Spain
    • Tel.: +34 933674100; fax: +34 933674266.
    • ,
  • Josefa Terrassa

      Affiliations

    • Oncology Service, Hospital Son Dureta, C/Andrea Doria 55, 07014 Palma Mallorca, Spain
    • Tel.: +34 971175000; fax: +34 971717140.
    • ,
  • Monserrat Gay

      Affiliations

    • Oncology Service, Hospital General de Vic, Plaza Francesc Pla El Vigatà 1, 08500 Vic, Spain
    • Tel.: +34 93889111; fax: +34 938850308.
    • ,
  • Monserrat Domenech

      Affiliations

    • Oncology Service, Centre Hospitalari i Cardiològic de Manresa, Avda. Bases de Manresa 6-8, 08240 Manresa, Spain
    • Tel.: +34 938730505; fax: +34 938700015.
    • ,
  • Romá Bastus

      Affiliations

    • Oncology Service, Hospital Mútua de Terrassa, Plaça Doctor Robert 5, 08221 Terrassa, Spain
    • Tel.: +34 937365050; fax: +34 937365059.
    • ,
  • Isabel Bover

      Affiliations

    • Oncology Service, Hospital Son Llatzer, Ctra. Manacor, Km 4, 07198 Palma de Mallorca, Spain
    • Tel.: +34 871202000; fax: +34 871202027.
    • ,
  • Miquel Nogué

      Affiliations

    • Oncology Service, Hospital General de Vic, Plaza Francesc Pla El Vigatà 1, 08500 Vic, Spain
    • Tel.: +34 93889111; fax: +34 938850308.
    • ,
  • Catalina Vadell

      Affiliations

    • Oncology Service, Hospital de Manacor, 07500 Manacor (Mallorca), Spain
    • Tel.: +34 971847000; fax: +34 971847010.
    • ,
  • On behalf of ACROSS

Received 26 October 2007 ,Revised 26 February 2008 ,Accepted 26 February 2008.

References 

  1. Grunenwald DH. Surgery for locally advanced non small cell lung cancer. Semin Surg Oncol. 2003;21:85–90
  2. Naruke T. Surgery in locally advanced non-small cell lung cancer. Lung Cancer. 2003;42(Suppl. 2):S11–S15[36 ref.]
  3. Curran W, Scott C, Langer C, Komaki R, Lee JS, Hauser S, et al. Long-term benefit is observed in a phase III comparison of sequential versus concurrent chemoradiation for patients with unresected stage III non small cell lung cancer: Radiation Therapy Oncology Group 9410. Proc Am Soc Clin Oncol. 2003;22:621;(abstract 2499)
  4. Furuse K, Fukuoka M, Kawahara M, Nishikawa H, Takada Y, Kudoh S, et al. Phase III study of concurrent versus sequential thoracic radiotherapy in combination with misogynic, intestine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol. 1999;17:2692–2699
  5. Zatloukal P, Petruzelka L, Zemanova M, Havel L, Janku F, Judas L, et al. Concurrent versus sequential chemoradiotherapy with cisplatin and vinorelbine in locally advanced non-small cell lung cancer: a randomized study. Lung Cancer. 2004;46:87–98
  6. Vokes EE, Herndon JE, Crawford J, Leopold KA, Perry MC, Miller AA, et al. Randomized phase II study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy followed by concomitant chemoradiotherapy for stage IIIB non-small-cell lung cancer: cancer and leukemia group B study 9431. J Clin Oncol. 2002;20:4191–4198
  7. Gandara DR, Chansky K, Albain KS, Leigh BR, Gaspar LE, Lara PN, et al. Southwest Oncology Group Consolidation docetaxel after concurrent chemoradiotherapy in stage IIIB non-small-cell lung cancer: phase II Southwest Oncology Group Study S9504. J Clin Oncol. 2003;21:2004–2010
  8. Fossella FV, Zinner RG, Komaki R, Lu R, Lee JS, Glisson BS, et al. Gemcitabine with concurrent chest radiation followed by consolidation gemcitabine plus cisplatin: a phase I trial for patients with stage III nonsmall cell lung cancer (NSCLC). Eur J Cancer. 2001;37(Suppl. 6):S53–S54
  9. Gregor A, Price A, van der Leest AHD, Scalliet P, Wets M, Jungnelius U, et al. Phase I study of gemcitabine and radiotherapy in stage III non-small cell lung cancer. Proc Am Soc Clin Oncol. 1999;18:1953a
  10. Trodella L, Granone P, Valente S, Turriziani A, Macis G, Corbo GM, et al. Phase I trial of weekly gemcitabine and concurrent radiotherapy in patients with inoperable nonsmall-cell lung cancer. J Clin Oncol. 2002;20(3):804–810
  11. Van Putten JWG, Price A, van der Leest AHD, Gregor A, Little FA, Groen HJM. A Phase I study of gemcitabine with concurrent radiotherapy in stage III, locally advanced non-small cell lung cancer. Clin Cancer Res. 2003;9:2472–2477
  12. Goor C, Scalliet P, Van Meerbeek J, et al. A phase II study combining gemcitabine and radiotherapy in stage III NSCLC. Proc 21st ESMO Ann Oncol. 1996;7(Suppl. 5):101a
  13. Salinas J, Serna A, de la Fuente I, de las Heras M, García R, Fernández J. Gemcitabina como radiosensibilizante en el carcinoma no microcítico de pulmón estadio III. Estudio fase I–II en pacientes con quimioterapia neoadyuvante. Rev Oncol. 2001;3(Suppl. 1):163
  14. Zajusz A, Zielonka I, Sygula D, Plewicki G, Nowicka E, Behrendt K, et al. Concurrent thoracic radiotherapy and weekly gemcitabine in an advanced non-small cell lung cancer. Radiother Oncol. 2000;56(Suppl. 1):S66
  15. Athanasiou E, Cyrgias G, Boinis K, Samantas E, Christodoulidou M, Tamvaki F, et al. Concurrent chemoradiotherapy with gemcitabine for locally advanced non-small cell lung cancer: preliminary results of a phase II study. Proc 23rd ESMO Ann Oncol. 1998;9:468a
  16. Fields MT, Eisbruch A, Normolle D, Orfali A, Davis MA, Pu AT, et al. Radiosensitization produced in vivo by once- vs. twice-weekly 2′2′-difluoro-2′-deoxycytidine (gemcitabine). Int J Radiat Oncol Biol Phys. 2000;47:785–791
  17. Blackstock AW, Case LD, Richards F, White D, Petty M, Scarantino C, et al. Twice-weekly gemcitabine and concurrent thoracic radiotherapy. A phase I/II study in patients with advanced non-small cell lung cancer (NSCLC). Proc 41st ASTRO Int J Radiat Oncol Bio Phys. 1999;45(Suppl. 3):242.183a
  18. Armstrong JG. Target volume definition for three-dimensional conformal radiation therapy of lung cancer. Br J Radiol. 1998;71:587–594
  19. ICRU. International Commission of Radiation Units and Measurements. Report 50 (1993) and Report 62 (1999).
  20. Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  21. Blackstock AW, Lesser GJ, Fletcher-Steede J, Case LD, Tucker RW, Russo SM, et al. Phase I study of twice-weekly gemcitabine and concurrent thoracic radiation for patients with locally advanced non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2001;51:1281–1289
  22. Wei X, Liu HH, Tucker SL, Liao Z, Hu C, Mohan R, et al. Risk factors for acute esophagitis in non-small-cell lung cancer patients treated with concurrent chemotherapy and three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66:100–107
  23. Robnett TJ, Machtay M, Vines EF, McKenna MG, Algazy KM, McKenna WG. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2000;48:89–94
  24. Rancati T, Ceresoli GL, Gagliardi G, Schipani S, Cattaneo GM. Factors predicting radiation pneumonitis in lung cancer patients: a retrospective study. Radiother Oncol. 2003;67:275–283
  25. Inoue A, Kunitoh H, Sekine I, Sumi M, Tokuuye K, Saijo N. Radiation pneumonitis in lung cancer patients: a retrospective study of risk factors and the long-term prognosis. Int J Radiat Oncol Biol Phys. 2001;49:649–655
  26. Hara R, Itami J, Komiyama T, Katoh D, Kondo T. Serum levels of KL-6 for predicting the occurrence of radiation pneumonitis after stereotactic radiotherapy for lung tumors. Chest. 2004;125:340–344
  27. Yamada M, Kudoh S, Hirata K, Nakajima T, Yoshikawa J. Risk factors of pneumonitis following chemoradiotherapy for lung cancer. Eur J Cancer. 1998;34:71–75
  28. Yorke ED, Jackson A, Rosenzweig KE, Merrick SA, Gabrys D, Venkatraman ES, et al. Dose-volume factors contributing to the incidence of radiation pneumonitis in nonsmall-cell lung cancer patients treated with three-dimensional conformal radiation therapy. Int J Radiat Oncol Biol Phys. 2002;54:329–339
  29. Kwa SLS, Lebesque JV, Theuws JC, Marks LB, Munley MT, Bentel G, et al. Radiation pneumonitis as a function of mean lung dose: an analysis of pooled data of 540 patients. Int J Radiat Oncol Biol Phys. 1998;42:1–9
  30. Hernando ML, Marks LB, Bentel GC, Zhou SM, Hollis D, Das SK, et al. Radiation-induced pulmonary toxicity: a dose-volume histogram analysis in 201 patients with lung cancer. Int J Radiat Oncol Biol Phys. 2001;51:650–659
  31. Makimoto T, Tsuchiya S, Hayakawa K, Saitoh R, Mori M. Risk factors for severe radiation pneumonitis in lung cancer. Jpn J Clin Oncol. 1999;29:192–197
  32. Graham MV, Purdy JA, Emami B, Harms W, Bosch W, Lockett MA, et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys. 1999;45:323–329
  33. Tsujino K, Hirota S, Endo M, Obayashi K, Kotani Y, Satouchi M, et al. Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2003;55:110–115
  34. Werner-Wasik M, Xiao Y, Pequignot E, Curran WJ, Hauck W. Assessment of lung cancer response after nonoperative therapy: tumor diameter, bidimensional product, and volume—a serial CT scan-based study. Int J Radiat Oncol Biol Phys. 2001;51:56–61
  35. Lever AM, Henderson D, Ellis DA, Corris PA, Gilmartin JJ. Radiation fibrosis mimicking local recurrence in small cell carcinoma of the bronchus. Br J Radiol. 1984;57:178–180
  36. Hicks RJ, Kalff V, Mac Manus MP, Ware RE, McKenzie AF, Matthews JP, et al. The utility of 18F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: impact on management and prognostic stratification. J Nucl Med. 2001;42:1605–1613
  37. Mac Manus MP, Hicks RJ, Matthews JP, McKenzie A, Rischin D, Salminen EK, et al. Positron emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy or chemoradiotherapy in patients with non-small-cell lung cancer. J Clin Oncol. 2003;21:1285–1292

PII: S0169-5002(08)00110-4

doi: 10.1016/j.lungcan.2008.02.024

Lung Cancer
Volume 62, Issue 1 , Pages 62-71 , October 2008

Article Tools

* Image Usage & Resolution