Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12029
Title: Comparison of toxicity and outcomes of concurrent radiotherapy with carboplatin/paclitaxel or cisplatin/etoposide in stage III non-small cell lung cancer.
Authors: Liew, Mun Sem;Sia, Joseph;Starmans, Maud H W;Tafreshi, Ali;Harris, Sam;Feigen, Malcolm;White, Shane C;Zimet, Allan;Lambin, Philippe;Boutros, Paul C;Mitchell, Paul L R;John, Thomas
Affiliation: Ludwig Institute for Cancer Research, Olivia Newton-John Cancer & Wellness Centre, Austin Health, Melbourne, Australia
Austin-Ludwig Oncology Unit, Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Australia
University of Melbourne, Melbourne, Australia
Department of Medicine, Austin Health, Melbourne, Australia
Issue Date: 16-Oct-2013
Citation: Cancer Medicine 2013; 2(6): 916-24
Abstract: Concurrent chemoradiotherapy (CCRT) has become the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). The comparative merits of two widely used regimens: carboplatin/paclitaxel (PC) and cisplatin/etoposide (PE), each with concurrent radiotherapy, remain largely undefined. Records for consecutive patients with stage III NSCLC treated with PC or PE and ≥60 Gy chest radiotherapy between 2000 and 2011 were reviewed for outcomes and toxicity. Survival was estimated using the Kaplan-Meier method and Cox modeling with the Wald test. Comparison across groups was done using the student's t and chi-squared tests. Seventy-five (PC: 44, PE: 31) patients were analyzed. PC patients were older (median 71 vs. 63 years; P = 0.0006). Other characteristics were comparable between groups. With PE, there was significantly increased grade ≥3 neutropenia (39% vs. 14%, P = 0.024) and thrombocytopenia (10% vs. 0%, P = 0.039). Radiation pneumonitis was more common with PC (66% vs. 38%, P = 0.033). Five treatment-related deaths occurred (PC: 3 vs. PE: 2, P = 1.000). With a median follow-up of 51.6 months, there were no significant differences in relapse-free survival (median PC 12.0 vs. PE 11.5 months, P = 0.700) or overall survival (median PC 20.7 vs. PE 13.7 months; P = 0.989). In multivariate analyses, no factors predicted for improved survival for either regimen. PC was more likely to be used in elderly patients. Despite this, PC resulted in significantly less hematological toxicity but achieved similar survival outcomes as PE. PC is an acceptable CCRT regimen, especially in older patients with multiple comorbidities.
Internal ID Number: 24403265
URI: http://ahro.austin.org.au/austinjspui/handle/1/12029
DOI: 10.1002/cam4.142
URL: http://www.ncbi.nlm.nih.gov/pubmed/24403265
Type: Journal Article
Subjects: Carboplatin/paclitaxel
cisplatin/etoposide
concurrent chemoradiotherapy
locally advanced
non-small cell lung cancer
stage III
Adult
Aged
Aged, 80 and over
Antineoplastic Agents.administration & dosage.adverse effects
Antineoplastic Combined Chemotherapy Protocols.administration & dosage.adverse effects
Carboplatin.administration & dosage.adverse effects
Carcinoma, Non-Small-Cell Lung.drug therapy.pathology.radiotherapy
Cisplatin.administration & dosage.adverse effects
Combined Modality Therapy
Etoposide.administration & dosage.adverse effects
Female
Humans
Kaplan-Meier Estimate
Lung Neoplasms.drug therapy.pathology.radiotherapy
Male
Middle Aged
Neoplasm Staging
Paclitaxel.administration & dosage.adverse effects
Appears in Collections:Journal articles

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