RADIOSENSITIZATION BY CYTOTOXIC DRUGS - THE EORTC EXPERIENCE BY THE RADIOTHERAPY AND LUNG-CANCER COOPERATIVE GROUPS

A three-arm randomized trial was performed to assess the acute and lat e toxicity and the impact on survival of the combination high-dose, sp lit-course radiotherapy with 30 mg/m2 cisplatin (cDDP) weekly, with 6 mg/m2 cisplatin daily compared to radiotherapy alone in patients with non-small cell lung cancer (NSCLC). The study started in May 1984 and was closed in May 1989 after 331 patients were randomised. The analysi s was performed after a minimum follow-up period of 22 months. Radioth erapy (RT) consisted of 30 Gy, 10 fractions, five fractions a week; th en a 3-week split followed by 25 Gy in 10 fractions. Nausea and vomiti ng were increased for a majority of the patients in the combined treat ment arms during treatment. There was no addition of bone marrow suppr ession, renal dysfunction or esophagitis. Increase of late radiation d amage was not observed. Local control (= absence of local progression) was improved for patients treated according to the daily cisplatin ar m. This has lead to an improvement in overall survival. There was no e ffect in time to distant metastasis due to the combined modality. The treatment influence was confirmed in the multivariate analysis. Conclu sion: local control and survival can be improved by combining radiothe rapy with daily low-dose cisplatin in patients with inoperable NSCLC.