Phase II trial of paclitaxel, carboplatin, and concurrent radiation therapy for locally advanced non-small-cell lung cancer

Ratanatharathorn, V.; Lorvidhaya, Vicharn; S, Maoleekoonpairoj; Phromratanapongse, Pramook; Sirilerttrakul, Suwannee; P, Kraipiboon; Cheirsilpa, Arkom; Tangkaratt, Saipin; Srimuninnimit, Vichien; Pattaranutaporn, Pitayapoon

doi:10.1016/s0169-5002(00)00171-9

Cited by 20 publications

(11 citation statements)

References 32 publications

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“…Extrapolating from the success of concurrent carboplatin and paclitaxel for non‐small cell lung cancer, van Meetern and colleagues showed the safety and efficacy of this concurrent chemotherapy regimen for esophageal cancer . In a follow‐up phase III randomized study of surgery with or without preoperative CRT with concurrent carboplatin and paclitaxel, the CROSS group reported an overall increase in median survival from 24 months after surgery alone to 49.4 months in patients receiving trimodality therapy .…”

Section: Introductionmentioning

confidence: 99%

Preoperative carboplatin and paclitaxel-based chemoradiotherapy for esophageal carcinoma: results of a modified CROSS regimen utilizing radiation doses greater than 41.4 Gy

et al. 2015

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Trimodality therapy for resectable esophageal and gastroesophageal junction cancers utilizing preoperative radiotherapy with concurrent carboplatin and paclitaxel-based chemotherapy is being increasingly utilized secondary to the results of the phase III CROSS trial. However, there is a paucity of reports of this regimen as a component of chemoradiotherapy in North America. We aim to report on our clinical experience using a modified CROSS regimen with higher radiotherapy doses. Patients with advanced (cT2-cT4 or node positive) esophageal or gastroesophageal junction carcinoma who received preoperative carboplatin/paclitaxel-based chemoradiotherapy with radiation doses of greater than 41.4 Gray (Gy) followed by esophagectomy were identified from an institutional database. Patient, imaging, treatment, and tumor response characteristics were analyzed. Twenty-four patients were analyzed. All but one tumor had adenocarcinoma histology. The median radiation dose was 50.4 Gy. Pathologic complete response was achieved in 29% of patients, with all receiving 50.4 Gy. Three early postoperative deaths were seen, due in part to acute respiratory distress syndrome and all three patients received 50-50.4 Gy. With a median follow-up of 9.4 months (23 days-2 years), median survival was 24 months. Trimodality therapy utilizing concurrent carboplatin/paclitaxel with North American radiotherapy doses appeared to have similar pathologic complete response rates compared with the CROSS trial, but may be associated with higher toxicity. Although the sample size is small and further follow-up is necessary, radiation doses greater than 41.4 Gy may not be warranted secondary to a potentially increased risk of severe radiation-induced acute lung injury.

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Section: Introductionmentioning

confidence: 99%

Preoperative carboplatin and paclitaxel-based chemoradiotherapy for esophageal carcinoma: results of a modified CROSS regimen utilizing radiation doses greater than 41.4 Gy

et al. 2015

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“…In five phase II studies, the combination of paclitaxel and carboplatin was given weekly with concurrent radiotherapy, followed by two or four 21-day cycles of consolidation chemotherapy (Choy et al, 1998(Choy et al, , 2000Lau et al, 2001;Ratanatharathorn et al, 2001;Kaplan et al, 2004). The overall response rate varied from 71 to 79%.…”

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confidence: 99%

Neoadjuvant concurrent chemoradiation with weekly paclitaxel and carboplatin for patients with oesophageal cancer: a phase II study

et al. 2006

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This study was performed to assess the efficacy and safety of preoperative chemoradiation consisting of carboplatin and paclitaxel and concurrent radiotherapy for patients with resectable (T2-3N0-1M0) oesophageal cancer. Treatment consisted of paclitaxel 50 mg m À2 and carboplatin AUC ¼ 2 on days 1, 8, 15, 22 and 29 and concurrent radiotherapy (41.4 Gy in 23 fractions, 5 days per week), followed by oesophagectomy. All 54 entered patients completed the chemoradiation without delay or dose-reduction. Grade 3 -4 toxicities were: neutropaenia 15%, thrombocytopaenia 2%, and oesophagitis 7.5%. After completion of the chemoradiotherapy 63% had a major endoscopical response. Fifty-two patients (96%) underwent a resection. The postoperative mortality rate was 7.7%. All patients had an R0-resection. The pathological complete response rate was 25%, and an additional 36.5% had less than 10% vital residual tumour cells. At a median follow-up of 23.2 months, the median survival time has not yet been reached. The probability of disease-free survival after 30 months was 60%. In conclusion, weekly neoadjuvant paclitaxel and carboplatin with concurrent radiotherapy is a very tolerable regimen and can be given on an outpatient basis. It achieves considerable down staging and a subsequent 100% radical resection rate in this series. A phase III trial with this regimen is now ongoing.

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“…In one study, esophagitis was the major toxicity, 8 while hematologic disorders were more frequent in the other study. 9 We did not encounter any adverse events during induction therapy, probably because we used lower doses than those reported previously and additional chemotherapy was not performed. The absence of adverse events meant that our patient could undergo surgery without delay.…”

Section: Discussionmentioning

confidence: 84%

Elimination of pancoast tumor by carboplatin, paclitaxel, and concurrent radiation

Utsumi

Suzuki

Sasaki

et al. 2004

Jpn J Thorac Cardiovasc Surg

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Preoperative chemoradiotherapy with carboplatin (AUC 1.5), paclitaxel (40 mg/m2), and concurrent extracorporeal radiation (40 Gy) was used to treat a Pancoast tumor (clinical T3N0M0), without causing adverse events. Then left upper lobectomy was performed along with mediastinal lymph node dissection plus resection of the chest wall and Th1 nerve root. Histological examination revealed a pathological complete response. This multimodal regimen was feasible and achieved a good response, so it seems worthwhile to evaluate the clinical effectiveness of the therapy in a cohort study.

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Phase II trial of paclitaxel, carboplatin, and concurrent radiation therapy for locally advanced non-small-cell lung cancer

Cited by 20 publications

References 32 publications

Preoperative carboplatin and paclitaxel-based chemoradiotherapy for esophageal carcinoma: results of a modified CROSS regimen utilizing radiation doses greater than 41.4 Gy

Preoperative carboplatin and paclitaxel-based chemoradiotherapy for esophageal carcinoma: results of a modified CROSS regimen utilizing radiation doses greater than 41.4 Gy

Neoadjuvant concurrent chemoradiation with weekly paclitaxel and carboplatin for patients with oesophageal cancer: a phase II study

Elimination of pancoast tumor by carboplatin, paclitaxel, and concurrent radiation

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