Abstract
ABSTRACT Background Full-dose concurrent platinum-based doublet chemotherapy and 2 Gy/day radiotherapy is the first choice treatment for most patients with stage III NSCLC. No prospective data are available on the acute toxicity of full-dose chemotherapy and high-dose hypofractionated accelerated radiotherapy. Here we report on a subset of patients included in the PET-boost trial that could not be randomised because dose escalation to the primary tumour over 72 Gy/ 24 fractions was not possible because of OAR constraints. Methods Patients received cisplatin 80 mg/m2 on day 1 and etoposide 100 mg/m2 on days 1-3 every 21 days for a total of three cycles. At day 1 of the second chemotherapy cycle, radiotherapy to the primary tumour and the involved lymph nodes was delivered (66 Gy /24 QD fractions of 2.75 Gy). Toxicity was evaluated weekly and scored according to CTCAE3.0. We considered the treatment safe when at maximum 5/12 developed G3 acute toxicity, reversible in at least 4/5 within 8 weeks post-therapy. Results 12 patients, 10 males, 2 females, mean age 66.9 years with stage III NSCLC were included. Mean PTV dose: 64.9 Gy. Mean fractions: 23.6. Mean OTT: 32.6 days. Mean MLD: 19.2 Gy, mean mean oesophageal dose 30.7 Gy, mean max oesophageal dose 60.4 Gy. Median follow-up: 9.9 months (range 3.3-15.1). G2 dyspnea: 1 (8.3 %). Maximal oesophagitis: G1: 2 (16.7 %), G2: 6 (50.0 %), G3: 4 (33.3 %), all recovering to G0 within 6 weeks post-treatment. Conclusions Full-dose cisplatin-etoposide was safely combined with high-dose hypofractionated accelerated radiotherapy. Disclosure All authors have declared no conflicts of interest.
Published Version
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