Outcomes of chemoradiation for patients with locally advanced non‐small‐cell lung cancer

Spina, Romina; Chu, Stephanie Y.Y.; Chatfield, Mark D.; Chen, J.; Tin, Mo Mo; Boyer, Michael

doi:10.1111/imj.12138

Cited by 6 publications

(3 citation statements)

References 21 publications

(57 reference statements)

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“…Results of this study also showed significant loss of body weight in rats bearing dysplasia or gastric/esophageal cancer. These data are in accordance with recent findings on patients with gastrointestinal cancers and lung cancer showing significant weight loss 19 , 20 . It is of interest to note that supplementation with MRN-100 provided significant protection against the body-weight loss in carcinogen-treated animals.…”

Section: Discussionsupporting

confidence: 93%

Hydroferrate Fluid, MRN-100, Provides Protection against Chemical-Induced Gastric and Esophageal Cancer in Wistar Rats

Ghoneum¹,

El-Din²,

Fattah³

et al. 2015

Int. J. Biol. Sci.

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In the current study, we examined the protective effect of hydroferrate fluid MRN-100 against the carcinogen methylnitronitrosoguanidine (MNNG)-induced gastric and esophageal cancer in rats. MRN-100 is an iron-based compound composed of bivalent and trivalent ferrates. At 33 weeks post treatment with MNNG, rats were killed and examined for the histopathology of esophagus and stomach; liver, spleen, and total body weight; and antioxidant levels in the blood and stomach tissues. Results showed that 17/20 (85%) gastroesophageal tissues from carcinogen MNNG-treated rats developed dysplasia and cancer, as compared to 8/20 (40%) rats treated with MNNG plus MRN-100. In addition, MRN-100 exerted an antioxidant effect in both the blood and stomach tissues by increasing levels of GSH, antioxidant enzymes SOD, CAT, and GPx, and total antioxidant capacity (TAC) level. This was accompanied by a reduction in the total free-radical and malondialdehyde levels. Furthermore, MRN-100 protected against body and organ weight loss. Thus, MRN-100 exhibited significant cancer chemopreventive activity by protecting tissues against oxidative damage in rats, which may suggest its effectiveness as an adjuvant for the treatment of gastric/esophageal carcinoma.

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Section: Discussionsupporting

confidence: 93%

Hydroferrate Fluid, MRN-100, Provides Protection against Chemical-Induced Gastric and Esophageal Cancer in Wistar Rats

Ghoneum¹,

El-Din²,

Fattah³

et al. 2015

Int. J. Biol. Sci.

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“…The 2 and 5 years absolute survival benefit of 4% and 2.2% compared to sequential CRT was reported in the meta-analysis by Aupérin et al (8). The estimated 5 year survival rate of 18.7% in our patient population is similar to the published retrospective data from New South Wales (Australia) by Spina et al (34) who reported a 17% estimated 5 year survival rate.…”

Section: Discussionsupporting

confidence: 88%

Survival and late toxicities following concurrent chemo-radiotherapy for locally advanced stage III non-small cell lung cancer: findings of a 10-year Australian single centre experience with long term clinical follow up

Abbas¹,

Ayoola²,

Padman³

et al. 2019

J. Thorac. Dis.

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Background: The preferred management of patients with unresectable locally advanced non-small cell lung cancer (LA-NSCLC) is concurrent chemo-radiotherapy (CRT). Acute CRT-related toxicities are well defined, however, less is known about late toxicities. The aim of the study was to examine the outcomes and late toxicities in Stage III NSCLC treated with CRT. Methods: A retrospective review of the data from patients with stage III NSCLC treated with CRT was performed between May 2000 and June 2010. Demographics, tumour and treatment characteristics, toxicities and survival data were examined from hospital records of the patients. Progression free survival (PFS) and overall survival (OS) were evaluated by standard Kaplan-Meier survival curves. The censor date was set on 31 October 2016. Results: Sixty-three patients were identified with a median age of 66.6 years [interquartile range (IQR) 57.2-72.1], two-third (n=41, 65.1%) were male, majority were current or ex-smokers (n=52, 82.5%), 42 (66.7%) patients had stage IIIB disease and 21 (33.3%) had stage IIIA disease. The most common histologic subtype was adenocarcinoma 30 (47.6%). The median PFS and OS of the whole population was 10.6 months (95% CI, 4.1-17.3 months) and 21 months (95% CI, 12.7-29.3 months) respectively.The 5-year OS rates for stage IIIA and IIIB were 24% and 16% respectively. The 1-, 3-and 5-year OS rates for all patients were 63.5%, 46% and 18.7% respectively. Acute grade 3 and 4 toxicities included 28 haematological and 17 non-haematological events. The incidence of late toxicities was 58.9%.Thirty-three events of late grade 3 and 4 toxicities were recorded. The most common late toxicity was symptomatic radiation-induced pulmonary fibrosis (39.3%), others include ototoxicity (7.1%), persistent dysphagia (7.1%) and one case of acute myeloid leukaemia. All patients that were alive at the censor date had developed radiation-induced fibrosis with associated symptoms of respiratory insufficiency. Conclusions:The 5-year OS of patients with stage III NSCLC treated with CRT was in keeping with survival figures reported from prospective clinical trials. There is, however, significant morbidity associated with long-term survival and this should be taken into account when making informed treatment decisions.

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“…1,2 However, overall outcomes still remain poor, with a 5-year overall survival (OS) rate of approximately 15% to 30%. [2][3][4] No major recent advances had been made until the publication of the PACIFIC trial, which established the role of durvalumab after CCRT. 5 There have been multiple studies evaluating the efficacy of different chemotherapy regimens in combination with radiotherapy (RT) since the 2000s, including etoposide-cisplatin (EP), weekly paclitaxel-carboplatin (PC), vinorelbine-cisplatin, and pemetrexed with either cisplatin or carboplatin.…”

Section: Introductionmentioning

confidence: 99%

Three-week Cycles of Paclitaxel-Carboplatin Administered Concurrently with Radiotherapy for Inoperable Stage III Non-small Cell Lung Cancer: 10-Year Single-Centre Experience

Wong¹,

Lim²,

Cheng³

2022

Hong Kong Journal of Radiology

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Introduction:We reviewed the efficacy, toxicities, and prognostic factors of two 3-week cycles of paclitaxelcarboplatin administered concurrently with radiotherapy for treatment of unresectable stage III non-small cell lung cancer (NSCLC). Methods: Cases of unresectable stage III NSCLC treated with chemoradiotherapy using paclitaxel 175 mg/m 2 and carboplatin area under the curve=5 on day 1 of a 21-day cycle concurrently with 6 weeks of radiotherapy (60-66 Gy) from 2007 to 2017 were retrieved. Results: A total of 65 patients (median age=63 years) were included. At a 29.5-month median follow-up, the median overall survival was 35.0 months (95% confidence interval [CI]=17.5-52.5 months). Multivariable Cox regression analyses showed that gross tumour volume (p = 0.001), mean heart dose ≥5 Gy (p = 0.007), and more than four cycles of chemotherapy administered (p = 0.006) were independent negative prognostic factors. The maximum grade toxicity was Grade 2 in 27 patients (41.5%), grade 3 in 13 patients (20.0%) and grade 4 in five patients (7.7%). No grade 5 events were observed. The most common grade 3 or 4 toxicity was neutropenia, which occurred in nine (13.8%) and five (7.7%) patients, respectively. Three patients (4.6%) had neutropenic fever. Grade ≥2 pneumonitis and oesophagitis were seen in five (7.7%) and nine (13.8%) patients, respectively. Conclusion: Two 3-week cycles of paclitaxel-carboplatin given concurrently with radiotherapy for unresectable stage III NSCLC was well-tolerated, with outcomes comparable to historical data, and fewer hospital visits.

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Outcomes of chemoradiation for patients with locally advanced non‐small‐cell lung cancer

Abstract: Our survival results are consistent with the recent international literature and indicate that a proportion of patients with locally advanced NSCLC can enjoy prolonged survival following treatment with concurrent chemoradiation.

Cited by 6 publications

References 21 publications

Hydroferrate Fluid, MRN-100, Provides Protection against Chemical-Induced Gastric and Esophageal Cancer in Wistar Rats

Hydroferrate Fluid, MRN-100, Provides Protection against Chemical-Induced Gastric and Esophageal Cancer in Wistar Rats

Survival and late toxicities following concurrent chemo-radiotherapy for locally advanced stage III non-small cell lung cancer: findings of a 10-year Australian single centre experience with long term clinical follow up

Three-week Cycles of Paclitaxel-Carboplatin Administered Concurrently with Radiotherapy for Inoperable Stage III Non-small Cell Lung Cancer: 10-Year Single-Centre Experience

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