PHASE-II STUDY OF CONCURRENT RADIOTHERAPY AND CHEMOTHERAPY FOR UNRESECTABLE STAGE-III NON-SMALL-CELL LUNG-CANCER

Purpose: To evaluate the response rate, toxicity, and 2-year survival rate of concurrent radiotherapy and chemotherapy for unresectable stag e III non-small-cell lung cancer (NSCLC). Patients and Methods: Betwee n July 1989 and October 1990, 65 patients with histologically or cytol ogically proven unresectable stage III NSCLC without T3N0-1M0 disease were entered onto this study. Sixty-one patients were eligible for res ponse, survival, and toxicity analysis. Chemotherapy consisted of vind esine (3 mg/m(2) on days 1, 8, 29, and 36), cisplatin (100 mg/m(2) on days 1 and 29), and mitomycin (8 mg/m(2) on days 1 and 29). Radiothera py was administered for 3 weeks (2 Gy given 13 times, five fractions p er week), followed by 10-day rest periods and then the previous schedu le of radiotherapy repeated for 3 weeks. Results: Of 61 eligible patie nts, 53 (86.9%) had a paratial response (PR). The median response dura tion was 39.1 weeks (range, 8.4 to 163+). The median survival time was 16 months and the 2-year survival rate was 36.7%. Of 53 responding pa tients, 10 (16.4%) are alive and disease-free after 2 years. The major toxicity was leukopenia (greater than or equal to grade 3, 95%). Othe r toxicities of greater than or equal to grade 3 included thrombocytop enia (45%), anemia (28%), nausea/vomiting (16%), fever (11%), and esop hagitis (6%), Treatment-related death occurred in two patients. One pa tient died of pulmonary toxicity (interstitial pneumonitis) and the ot her of esophagobronchial fistula with pulmonary infection. Conclusion: Concurrent radiotherapy plus chemotherapy, with mitomycin, vindesine, and cisplatin (MVP) can be safely administered to patients with stage III NSCLC, with excellent response rates and 5-year survival rates. J Clin Oncol 13:869-875. (C) 1995 by American Society of Clinical Oncol ogy.