Source: Annual Congress 2002 - Thoracic oncology: clinical management
Disease area: Thoracic oncology

Abstract

Concurrent CTE and TRT has shown promising results in patients (pts) with LD-SCLC (Hainsworth,1997). The feasibility and efficacy of CTE and early TRT was studied in a Dutch multicenter study. From 01/1999 till 12/2001, 38 pts were enrolled to receive 4 courses of C (AUC 6), T (200 mg/m2 IV in 3 h) and E (2 x 50 mg/day for 5 days p.o., q 3 weeks. TRT was given to the primary tumor and involved lymph nodes (25 fractions of 1.8 Gy/day, total dose of 45 Gy) starting day 3 of the second course. Prophylactic cranial irradiation (PCI) (12 x 2.5 Gy) was offered to responding pts after completion of chemotherapy. Eligible pts had a diagnosis of SCLC-LD, ECOG PS 0-1, measurable or evaluable disease, WBC >3.0 x109/l, platelets >100 x 109/l, LDH < 1.5x ULN, no major organ dysfunction and gave informed consent. Results: 26 pts (17 men, ECOG PS 0 in 50%; median age 58 years) have completed the treatment and received 98 of the 104 planned courses. Grade 3/4 toxicities were as follows:grade 3/4 granulocytopenia (70%),neutropenic fever (9), thrombocytopenia (35), nausea (4), vomiting (4), cardiovascular (4), lethargy (8).TRT related toxicities were: esophagitis grade 1/2 (15 pts), grade 3(7), pneumonitis grade 2 (1. Responses: CR 38%, PR 54%, NE 8%. Median survival is 19.7 months. Brain recurrences were found in 15% of the cases. Conclusion: We confirm the activity of CTE with early concurrent TRT, but at the cost of significant hematological toxicity. Early TRT of the primary tumor and involved lymph nodes is considered safe.

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J. P. van Meerbeeck, J. Belderbos, N. Van Zandwijk, S. Senan, O. Dalesio, H. B. Kwa, A. van Bochove, C. Weenink, W. Strankinga, P. Baas (Rotterdam, Amsterdam, Zaandam, Haarlem, The Netherlands). Carboplatin (C), paclitaxel (T) and etoposide (E) and early concurrent thoracic radiotherapy (TRT) for patients with limited disease small cell lung cancer (LD-SCLC): a Dutch multicentre phase 2 study. Eur Respir J 2002; 20: Suppl. 38, 1192

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