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Concurrent cisplatin(CDDP)-etoposide(VP) chemotherapy plus Thoracic Radiotherapy(TRT) for stageIII Small Cell Lung Cancer(SCLC): A Japanese Lung Cancer Chemotherapy Group (JLCCG) study
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Concurrent cisplatin(CDDP)-etoposide(VP) chemotherapy plus thoracic radiotherapy(TRT) for Stage111 small cell lung cancer(SCLC): A Japanese Lung Cancer Chemotherapy Group (JLCCG) study. S.Nakamura, H.Ikegami, M.Fukuoka, K.Furuse, Y.Ariyosi, N.Nisiwaki, M.Oritu, N.Saijo, and JLCCG supported by Grants-in-Aid from M.Shimoyama. the Ministry of Health and Welfare, Japan
Preliminary results of a pilot study of induction therapy with cisplatin(CDDP) , carboquone(CQ) , OK-432(Picivanil) and chest irradiation prior to surgical resection in locally advanced non-small cell lung cancer. M. Horiuchil, H. Iwanaga’, R. Yoh’, I. Nakarai*, R. Hayashida”, A. Hayashi I and T. Kakegawa”, Department of Surgery’, National Sanatorium, Ohmuta Hospital, 1044-1, Tachibana Ohmuta, 837, Japan, National Tokyo Second Hospital’, Koga Hospitals, First
66 previously From Nov. 1989 to Aug. 1990, untreated stage111 SCLC patients had entered a phase11 trial of concurrent CDDP/VP(PE) chemotherapy Chemotherapy schedule was CDDP 8Omg/m2 and TRT. dl and VP lOOmg/m2 d1,2,3, every 4wks for 4 courses. TRT was given 2Gy/d, on d2-12 and on d29-47(up to Fifty nine pts were eligible: 49 male, 10 50Gy). The median female; 8 PS 0, 40 PS 1, and 11 PS 2. Twenty four pts achieved age was 65(range 28-74). was 94.9%. CR (40,7%) and overall response rate The median response duration was 8.8 mo, MST was rate was 62%. Currently 15.1 mo, and 1-yr survival 39 pts(66%) relapsed. The first relapse site was brain in 9 pts(l5%), within the RT portal in 8(14%), Grade )3 leukopenia was observed and others in 22. in 60%, thrombocytopenia in 42%, anemia in 38%. Nine pts experienced mild to moderate esophagitis. Although there were two TRD(3%), we consider that concurrent PE-TRT could be administered with acceptable toxicity.
Department of Surgery4, Kurume University School of Medicine. In attempt to evaluate the possibility whether to downstage the tumor and achieve increased resectability rate and long-term survival, 7 patients with locally advanced nonsmall cell lung cancer(6 squamous cell carcinoma,, 1 adenocarcinoma) were treated preoperatively with three cycles of CDDP 70mg/m2(Dayl), CQ 7-14mg/mP(Day2) chemotherapy and chest irradiation(20 Gy in 10 fractions, concomitantly with the last cycle of chemotherapy). The response rate to preoperative induction chemo radiotherapy was 71.4% (1 complete, 4 partial, and 2 minor responses). Surgical resection was carried out in 5 patients. One patient refused the operation, and one patient was inoperable because of persistent poor cardiopulmonary reserve. All surgical specimens were investigated to assess the pathological response. One patient had no evidence of residual cancer in the resected lung or regional lymph nodes, 2 patients had microscopic residual cancer, and 2 had gross residual cancer. This pilot study demonstrates the feasibility of preoperative combined modality in non small cell lung cancer, and further studies are needed for evaluation.
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Neoadjuvant chemotherapy for N2 non small cell lung cancer Hirohito Tada, Takashi Mori, Kiyoyuki Furuse, Masunari Yamamoto, Tutomu Yasumitu, Masahiro Fukuoka and Nobuhide Takifuji. National Kinki Central Hospital for Chest Disease and Prefectural Habikino Hospital, Osaka 583, Japan To evaluate the efficacy and feasibility of neoadjuvant chemotherapy for N2 disease of NSCLC 34 patients was entered in this study with mediastinostopically confirmed disease. Each patients received 2 courses of CDDP 120mg/ma, MMC 8mg/m' on day 1 and VDS 3mg/m' on day 1 and 8. After the chemotherapy, operation was performed. 30 patients were eligible for analysis. 15 out of 30 patients had more than 2 levels of mediastinal lymph node metastasis. Response rate to the chemotherapy was 23% (7PR, lOMR, 1lNC and 2PD). 23 out of 30 patients were resected, 4 patients were unresectable (2 were too advanced, 1 brain metastasis and 1 intolerable for operation), and 3 were on going. Operative complications were minor and no surgery related death occered. One patient had no evidence of tumor and 5 patients had no evidence of mediastinal lymph node metastasis at operation. Up to now only 3 patients out of 23 who had operation were died; 2 were died of relapse and 1 gastric cancer. On the other hand, all 3 out of 4 inoperative patients were died of cancer. Although the response rate of the chemotherapy was lower than expected, this regimen was rather safe and could be a candidate for phase III study.
RADIOTHERAPY (RT) VERSUS R-fENHANCED BY CISPLATIN (DDP) IN STAGE III NON-SMALL CELL LUNG CANCER (NSCLC): RANWMIZED COOPERATIVE STUDY. TrovC,MG, Minatel E, Franchin G, Gobitti C, Innocente R, Veronesi A, Crivellari D,Nascimben 0, Boccieri MG, BolziccoG, Mazza F, Pizzi GB, Torretta A, Monfardini S. Forthe North-Eastern Italian OnCOlogy Group(GOCCNE) Operation OfficeC.R.0. - Aviano (PN), Italy. Daily low-dose DDP plus HP was used in a pilot study atour Institution in 90 evaluable pts with NSCLC obtai ning 16% complete remissions (CR) and 37% partial remissions (PR). To confirm the efficacy of the combined treatment,a randomized cooperative trial comparing RT alone vs Kr plus DDP was started in fan. '87. 180 pts -163 males and 17 females- with a median age of 60 yrs (36-70) and a median PS of 80 (60-100) entered the study. 4 pts were not eligible. 129 pts had epidermoid ca, 34adenoca, 13 large cell ca. RT consisted of 45Gy/15f2;/ /3wks to the tumor and mediastinum (spinal cord dose was30 Gy). DD; was given 1 h. before irradiation at tie dose of 6mg/m i.v. daily. The 176 eligible pts were randomizedto RT alone (89) and to the combined treatment (87). 43 pts were not evaluable. Response was ob served in 37 pts (55%) out of the 67 evaluable pts in arm I (9 CR and 28 PR) and in 33 (50%) out of the 66 ptsin arm II (10 CR and 23 PR). No differences between Rrand RT plus DDP have emerged for response rata and survival.Both treatments were well tolerated.
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Concurrent cisplatin(CDDP)-etoposide(VP) chemotherapy plus thoracic radiotherapy(TRT) for Stage111 small cell lung cancer(SCLC): A Japanese Lung Cancer Chemotherapy Group (JLCCG) study. S.Nakamura, H.Ikegami, M.Fukuoka, K.Furuse, Y.Ariyosi, N.Nisiwaki, M.Oritu, N.Saijo, and JLCCG supported by Grants-in-Aid from M.Shimoyama. the Ministry of Health and Welfare, Japan
Preliminary results of a pilot study of induction therapy with cisplatin(CDDP) , carboquone(CQ) , OK-432(Picivanil) and chest irradiation prior to surgical resection in locally advanced non-small cell lung cancer. M. Horiuchil, H. Iwanaga’, R. Yoh’, I. Nakarai*, R. Hayashida”, A. Hayashi I and T. Kakegawa”, Department of Surgery’, National Sanatorium, Ohmuta Hospital, 1044-1, Tachibana Ohmuta, 837, Japan, National Tokyo Second Hospital’, Koga Hospitals, First
66 previously From Nov. 1989 to Aug. 1990, untreated stage111 SCLC patients had entered a phase11 trial of concurrent CDDP/VP(PE) chemotherapy Chemotherapy schedule was CDDP 8Omg/m2 and TRT. dl and VP lOOmg/m2 d1,2,3, every 4wks for 4 courses. TRT was given 2Gy/d, on d2-12 and on d29-47(up to Fifty nine pts were eligible: 49 male, 10 50Gy). The median female; 8 PS 0, 40 PS 1, and 11 PS 2. Twenty four pts achieved age was 65(range 28-74). was 94.9%. CR (40,7%) and overall response rate The median response duration was 8.8 mo, MST was rate was 62%. Currently 15.1 mo, and 1-yr survival 39 pts(66%) relapsed. The first relapse site was brain in 9 pts(l5%), within the RT portal in 8(14%), Grade )3 leukopenia was observed and others in 22. in 60%, thrombocytopenia in 42%, anemia in 38%. Nine pts experienced mild to moderate esophagitis. Although there were two TRD(3%), we consider that concurrent PE-TRT could be administered with acceptable toxicity.
Department of Surgery4, Kurume University School of Medicine. In attempt to evaluate the possibility whether to downstage the tumor and achieve increased resectability rate and long-term survival, 7 patients with locally advanced nonsmall cell lung cancer(6 squamous cell carcinoma,, 1 adenocarcinoma) were treated preoperatively with three cycles of CDDP 70mg/m2(Dayl), CQ 7-14mg/mP(Day2) chemotherapy and chest irradiation(20 Gy in 10 fractions, concomitantly with the last cycle of chemotherapy). The response rate to preoperative induction chemo radiotherapy was 71.4% (1 complete, 4 partial, and 2 minor responses). Surgical resection was carried out in 5 patients. One patient refused the operation, and one patient was inoperable because of persistent poor cardiopulmonary reserve. All surgical specimens were investigated to assess the pathological response. One patient had no evidence of residual cancer in the resected lung or regional lymph nodes, 2 patients had microscopic residual cancer, and 2 had gross residual cancer. This pilot study demonstrates the feasibility of preoperative combined modality in non small cell lung cancer, and further studies are needed for evaluation.
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Neoadjuvant chemotherapy for N2 non small cell lung cancer Hirohito Tada, Takashi Mori, Kiyoyuki Furuse, Masunari Yamamoto, Tutomu Yasumitu, Masahiro Fukuoka and Nobuhide Takifuji. National Kinki Central Hospital for Chest Disease and Prefectural Habikino Hospital, Osaka 583, Japan To evaluate the efficacy and feasibility of neoadjuvant chemotherapy for N2 disease of NSCLC 34 patients was entered in this study with mediastinostopically confirmed disease. Each patients received 2 courses of CDDP 120mg/ma, MMC 8mg/m' on day 1 and VDS 3mg/m' on day 1 and 8. After the chemotherapy, operation was performed. 30 patients were eligible for analysis. 15 out of 30 patients had more than 2 levels of mediastinal lymph node metastasis. Response rate to the chemotherapy was 23% (7PR, lOMR, 1lNC and 2PD). 23 out of 30 patients were resected, 4 patients were unresectable (2 were too advanced, 1 brain metastasis and 1 intolerable for operation), and 3 were on going. Operative complications were minor and no surgery related death occered. One patient had no evidence of tumor and 5 patients had no evidence of mediastinal lymph node metastasis at operation. Up to now only 3 patients out of 23 who had operation were died; 2 were died of relapse and 1 gastric cancer. On the other hand, all 3 out of 4 inoperative patients were died of cancer. Although the response rate of the chemotherapy was lower than expected, this regimen was rather safe and could be a candidate for phase III study.
RADIOTHERAPY (RT) VERSUS R-fENHANCED BY CISPLATIN (DDP) IN STAGE III NON-SMALL CELL LUNG CANCER (NSCLC): RANWMIZED COOPERATIVE STUDY. TrovC,MG, Minatel E, Franchin G, Gobitti C, Innocente R, Veronesi A, Crivellari D,Nascimben 0, Boccieri MG, BolziccoG, Mazza F, Pizzi GB, Torretta A, Monfardini S. Forthe North-Eastern Italian OnCOlogy Group(GOCCNE) Operation OfficeC.R.0. - Aviano (PN), Italy. Daily low-dose DDP plus HP was used in a pilot study atour Institution in 90 evaluable pts with NSCLC obtai ning 16% complete remissions (CR) and 37% partial remissions (PR). To confirm the efficacy of the combined treatment,a randomized cooperative trial comparing RT alone vs Kr plus DDP was started in fan. '87. 180 pts -163 males and 17 females- with a median age of 60 yrs (36-70) and a median PS of 80 (60-100) entered the study. 4 pts were not eligible. 129 pts had epidermoid ca, 34adenoca, 13 large cell ca. RT consisted of 45Gy/15f2;/ /3wks to the tumor and mediastinum (spinal cord dose was30 Gy). DD; was given 1 h. before irradiation at tie dose of 6mg/m i.v. daily. The 176 eligible pts were randomizedto RT alone (89) and to the combined treatment (87). 43 pts were not evaluable. Response was ob served in 37 pts (55%) out of the 67 evaluable pts in arm I (9 CR and 28 PR) and in 33 (50%) out of the 66 ptsin arm II (10 CR and 23 PR). No differences between Rrand RT plus DDP have emerged for response rata and survival.Both treatments were well tolerated.