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

Abstract

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.