Long-Term Results of a Phase II Trial of Induction Paclitaxel-Carboplatin Followed by Concurrent Radiation Therapy and Weekly Paclitaxel and Consolidation Paclitaxel-Carboplatin in Stage III Non-small Cell Lung Cancer

Introduction: Long-term results of a phase II study on the use of induction chemotherapy (CHT) using paclitaxel (P)-carboplatin (C) followed by a concurrent radiation therapy (RT) and weekly P and consolidation PC were reviewed. Patients and Methods: Thirty-two patients with stage III non-small cell lung cancer started treatment with induction CHT (two cycles of P 175 mg/m2, day 1 and C, area under the curve 6, day 1, given at 3-week interval), after which accelerated RT with a concomitant boost ("field-in-a-field") (1.8 Gy large fields and the boost dose 0.88 Gy) was administered in 23 fractions with 61.64 Gy and concurrent weekly P (45 mg/m2). Consolidation with two cycles of PC was administered. Results: The median follow-up for all 32 patients was 17.2 months (range, 3.8-107 months). The median survival time was 16.9 months, and the 5-year survival and 10-year survival were 25% and 17.5%, respectively. The median time for disease progression was 9.5 months, and disease-free survival was 21% at 5 and 10 years. The median time to local progression was 14.6 months, and the 5- to 10-year local progression-free survival was 35.7%. The median time to distant metastasis was 17.5 months. Toxicity was acceptable, with only one (3.1%) patient experiencing grade 5 (lung) toxicity and another patient presenting grade 4 toxicity (leucopenia). Conclusions: The results of this single-institutional phase II study of induction CHT followed by concurrent RT-CHT and consolidation CHT in very unfavorable patient population showed acceptable results with acceptable toxicity.