ALTERNATING IRRADIATION AND CHEMOTHERAPY IN STAGE-III-A AND STAGE-III-B NONSMALL CELL LUNG-CANCER - REPORT OF A CANCER AND LEUKEMIA GROUP-BPHASE-II STUDY-8636

Purpose: A pilot trial testing the feasibility of chemotherapy and rad iotherapy was done in Stage III A and B nonsmall cell lung cancer. The schedule was designed to be consistent with the laboratory model of L ooney and Hopkins. Methods and Materials: Treatment began with thrice- per-day radiotherapy for 3 days (16.2 Gy/nine fractions), followed by chemotherapy (cis-platinum 100 mg/m(2) day 10, and vinblastine 4 mg/m( 2) days 10 and 12). A second cycle started on day 22, a third on day 4 3, and a fourth on day 64. We treated three cohorts. The first cohort received three cycles of radiotherapy alone, (48.6 Gy). The second coh ort received three completed cycles, and the third received three comp leted cycles and a fourth radiotherapy course (64.8 Gy). Patients were evaluated for toxicity, protocol compliance, response, and survival. Results: The patients in the first cohort experienced no toxicity. Fif ty-six percent (56%) of the patients treated in cohort 2 experienced s evere or life-threatening myelosuppression as did 82% of those in coho rt 3. Nonhematologic toxicity was not severe; one case of Grade 3 esop hagitis, one of reversible adult respiratory distress syndrome, and on e radiation pneunomitis. We closed the trial after accrual to the thir d cohort because of significant myelosuppression. Conclusion: This sch edule is too myelosuppressive to be used without modification.