Hyperfractionated radiation therapy and concurrent low-dose, daily carboplatin/etoposide with or without weekend carboplatin/etoposide chemotherapy in stage III non-small-cell lung cancer: A randomized trial

Purpose: To investigate whether the addition of weekend chemotherapy consis ting of carboplatin/etoposide to hyperfractionated radiation therapy (Hfx R T) and concurrent daily carboplatin/etoposide offers an advantage over the same Hfx RT/daily carboplatin/etoposide. Methods and Materials: A total of 195 patients (Group I, 98; Group II, 97) were treated with either Hfx RT to a total tumor dose of 69.6 Gy via 1.2 Gy b.i.d. fractionation and daily 50 mg each of carboplatin and etoposide dur ing the RT course (Group I) or the same Hfx RT with daily carboplatin/etopo side consisting of 30 mg each of carboplatin and etoposide and with weekend (Saturdays and Sundays) 100 mg each of carboplatin and etoposide during th e RT course (Group II). Results: No difference was found regarding median survival time and 5-year survival rates (20 vs. 22 months and 20% vs. 23%; p = 0.57). Median time to local progression was 20 and 19 months, respectively, while 5-year local p rogression-free survival rates were 28% and 27%, respectively (p = 0.66). A lso, there was no difference regarding either median time to distant metast asis and 5-year distant metastasis-free survival (21 vs. 25 months and 29% vs. 34%, p = 0.29). There was no difference in the incidence of various non hematologic toxicities between the two treatment groups, but patients treat ed with the weekend CHT had significantly more high-grade (greater than or equal to 3) hematologic toxicity (p = 0.0046). Late high-grade toxicity was not different between the two treatment groups. Conclusion: The addition of weekend carboplatin/etoposide did not improve r esults over those obtained with Hfx RT and concurrent low-dose, daily carbo platin/etoposide, but it led to a higher incidence of acute high-grade hema tologic toxicity. (C) 2001 Elsevier Science Inc.