A Phase I Study of Chemoradiotherapy With Use of Involved-Field Conformal Radiotherapy and Accelerated Hyperfractionation for Stage III Non-Small Cell Lung Cancer: WJT0G 3305

作者：Tada Takuhito^*; Chiba Yasutaka; Tsujino Kayoko; Fukuda Haruyuki; Nishimura Yasumasa; Kokubo Masaki; Negoro Shunichi; Kudoh Shinzoh; Fukuoka Masahiro; Nakagawa Kazuhiko; Nakanishi Yoichi

来源：International Journal of Radiation Oncology, Biology, Physics, 2012, 83(1): 327-331.

DOI：10.1016/j.ijrobp.2011.06.1991

• Non-small-cell lung cancer
• Chemoradiation
• Three-dimensional conformal radiotherapy
• Accelerated hyperfractionation
• Dose escalation

Purpose: A Phase I study to determine a recommended dose of thoracic radiotherapy using accelerated hyperfractionation for unresectable non-small-cell lung cancer was conducted. %26lt;br%26gt;Methods and Materials: Patients with unresectable Stage III non-small-cell lung cancer were treated intravenously with carboplatin (area under the concentration curve 2) and paclitaxel (40 mg/m(2)) on Days 1, 8, 15, and 22 with concurrent twice-daily thoracic radiotherapy (1.5 Gy per fraction) beginning on Day 1 followed by two cycles of consolidation chemotherapy using carboplatin (area under the concentration curve 5) and paclitaxel (200 mg/m(2)). Total doses were 54 Gy in 36 fractions, 60 Gy in 40 fractions, 66 Gy in 44 fractions, and 72 Gy in 48 fractions at Levels 1 to 4. The dose-limiting toxicity, defined as Grade %26gt;= 4 esophagitis and neutropenic fever and Grade %26gt;= 3 other nonhematologic toxicities, was monitored for 90 days. %26lt;br%26gt;Results: Of 26 patients enrolled, 22 patients were assessable for response and toxicity. When 4 patients entered Level 4, enrollment was closed to avoid severe late toxicities. Dose-limiting toxicities occurred in 3 patients. They were Grade 3 neuropathy at Level 1 and Level 3 and Grade 3 infection at Level 1. However, the maximum tolerated dose was not reached. The median survival time was 28.6 months for all patients. %26lt;br%26gt;Conclusions: The maximum tolerated dose was not reached, although the dose of radiation was escalated to 72 Gy in 48 fractions. However, a dose of 66 Gy in 44 fractions was adopted for this study because late toxicity data were insufficient.

• 出版日期2012-5-1