American Society of Clinical Oncology Treatment of Unresectable Non–Small-Cell Lung Cancer Guideline: Update 2003

Pfister, David G.; Johnson, David H.; Sause, William T.; Smith, Thomas J.; Baker, Sherman; Olak, Jemi; Stover, Diane E.; Strawn, John R.; Turrisi, Andrew T.; Somerfield, Mark R.

doi:10.1200/jco.2004.09.053

Cited by 1,315 publications

(840 citation statements)

References 259 publications

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“…Current recommendations include platinum-or taxane-based doublets with concurrent RT regimen that keep the lung cancer at bay for a time in most patients [22][23][24]. Sekine I and Nokihara H revealed that cisplatin, vinorelbine concurrent TRT before docetaxel consolidation therapy resulted in 81, 81, 10, 10% of patients associated with grade 3/4 leukopenia, neutropenia, pneumonitis, esophagitis in unresectable stage III NSCLC [25].…”

Section: Discussionmentioning

confidence: 99%

Concurrent chemoradiotherapy with weekly nedaplatin versus radiotherapy alone in elderly patients with non-small-cell lung cancer

Chen

Liang

et al. 2017

Clin Transl Oncol

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Purpose We conduct this study to compare the efficacy and toxicity of intensity-modulated radiotherapy (IMRT) concurrent weekly nedaplatin (NDP) versus IMRT alone in the stage III/IV non-surgical elderly patients with nonsmall-cell lung cancer (NSCLC). Methods 117 patients were enrolled into our study. The patients were assigned into two different groups: radiotherapy (RT) group and chemoradiotherapy (CRT) group. Patients in RT group were treated with IMRT at a single daily dose of 2 Gy for 5 days per week, totally 52-66 Gy. The CRT group, IMRT concurrent weekly NDP at a dose of 25 mg/m 2 . Results In CRT group, the median survival was 11.0 months (95% confidence interval [CI], 8.894-13.106 months) and in RT group, it was 7.0 months (95% CI 5.771-8.229 months). The 1-year, 2-year, 3-year, survival rates in the combined treatment arm were higher than the radiation therapy arm (46.8 vs 25.9%, 25.1 vs 11.8%, 14.7 vs 8.0%; p \ 0.001). The Cox's multiple regression analysis showed that CRT had significantly better overall survival than RT (HR 0.523; 95.0% CI 0.338-0.807; p = 0.003). The objective response rate provided that 73.3% treated with CRT compared with 51.1% (p = 0.018) received RT alone. Of the hematologic toxicities, leukocytes (35.0 vs 0%; p \ 0.001), neutrophils (33.3 vs 0%; p \ 0.001) were significantly more common in the CRT group than the RT group. Conclusions We first discovered that NDP concurrent IMRT for treating stage III/IV non-surgical elderly patients with NSCLC was good curative effect of better objective response rate and well-tolerated. However, within the low number of patients, only stage IV gained a survival benefit.

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Section: Discussionmentioning

confidence: 99%

Concurrent chemoradiotherapy with weekly nedaplatin versus radiotherapy alone in elderly patients with non-small-cell lung cancer

Chen

Liang

et al. 2017

Clin Transl Oncol

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“…Platinum-based combination chemotherapy is recommended for the treatment of advanced NSCLC patients with a good performance status (Pfister et al, 2004). However, the incidence of severe adverse effects induced by this combination chemotherapy is indeed more frequently observed in elderly patients than younger patients even if the subjects have good performance status (Langer et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

UFT plus gemcitabine combination chemotherapy in patients with advanced non-small-cell lung cancer: a multi-institutional phase II trial

et al. 2005

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A multi-institutional phase II trial was conducted to evaluate the efficacy and toxicity of combination chemotherapy consisting of gemcitabine and UFT, which is composed of tegafur and uracil, for non-small-cell lung cancer (NSCLC) patients. Patients with advanced NSCLC received an oral administration of UFT (tegafur 200 mg m À2 ) b.i.d. from days 1 to 14 and intravenous injection of gemcitabine 900 mg m À2 on days 8 and 15. This treatment was repeated every 4 weeks. A total of 44 patients were enrolled into this trial. The median age of all patients was 74 years, with 23 patients younger than 75 years and 21 patients with 75 years of age or older. A total of 18 patients (41%) achieved a partial response. The median survival time was 13.2 months and the 1-year survival rate was 59%. The most common grade 3 -4 toxicity was neutropenia (57%). The frequency of grade 3 nonhaematologic toxicities was less than 5%. In addition, no significant difference in the response, survival or toxicities was observed between the patients younger than and those older than 75 years of age. This combination chemotherapy demonstrated a promising effectiveness and acceptable toxicity in patients with advanced NSCLC, even in patients older than 75 years.

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“…In the same time, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) as gefitinib emerged as an accepted treatment in second-or third-line setting in NSCLC (Pfister et al, 2004). However, clinical surrogate markers of EGFR-TKI activity in NSCLC patients after failure of platinum-containing regimen remain to be identified.…”

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confidence: 99%

CYFRA 21-1 level predicts survival in non-small-cell lung cancer patients receiving gefitinib as third-line therapy

et al. 2004

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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) as gefitinib emerged as an accepted treatment in second-or third-line setting in NSCLC. However, clinical surrogate markers of EGFR-TKI activity in NSCLC patients remain to be identified and we studied the prognostic value of CYFRA 21-1 in this setting. Serum samples from 53 patients with NSCLC receiving gefitinib after failure of at least a platinum-containing regimen were prospectively collected from January 2002 to December 2003. Multivariate analysis demonstrated an independent negative impact on survival for a level of CYFRA 21-1 higher than 3.5 ng ml À1 (HR ¼ 2.45, 95% CI 1.13 -5.29; P ¼ 0.02). In conclusion, CYFRA 21-1 is a tool available to predict the survival of NSCLC patients receiving gefitinib as third-line therapy in an independent manner. In case of a CYFRA 21-1 level higher than 3.5 ng ml À1 , treatment with gefitinib needs further evaluation giving its relative poor effect on survival.

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American Society of Clinical Oncology Treatment of Unresectable Non–Small-Cell Lung Cancer Guideline: Update 2003

Cited by 1,315 publications

References 259 publications

Concurrent chemoradiotherapy with weekly nedaplatin versus radiotherapy alone in elderly patients with non-small-cell lung cancer

Concurrent chemoradiotherapy with weekly nedaplatin versus radiotherapy alone in elderly patients with non-small-cell lung cancer

UFT plus gemcitabine combination chemotherapy in patients with advanced non-small-cell lung cancer: a multi-institutional phase II trial

CYFRA 21-1 level predicts survival in non-small-cell lung cancer patients receiving gefitinib as third-line therapy

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