Efficacy of weekly paclitaxel and concurrent radiation therapy for locally advanced non-small cell lung cancer

Background : Combined modality therapy is standard treatment of unresectable, locally advanced stage III non-small cell lung cancer (NSCLC). However, the optimal chemotherapy regimen and duration of chemotherapy remain a matter of debate. We evaluated the efficacy and feasibility of concurrent chemoradiation therapy (CCRT) in patients with locally advanced NSCLC. Methods : PS 0-2 patients with histologically proven inoperable stage III NSCLC were eligible for this trial. The patients received paclitaxel (60 ) on days 1, 8, 15, 22, 29, 36 with a concurrent radiotherapy (5 days/week, 1.8 Gy/day) starting day 1 with a total dose of 63 Gy. After CCRT, four cycles of consolidation chemotherapy with paclitaxel (140 ) and carboplatin (AUC 5) was administered to patients with a partial, complete remission or stable disease. Results : Twenty eight patients with locally advanced NSCLC enrolled in this study. The median age of the patients was 60 years. Of the 28 patients, 19 received scheduled CCRT. Overall response rate was 71.4% including 5 complete responses and 15 partial responses. Grade 3 or 4 pulmonary complication was observed in 7 patients and 3 patients died of pneumonitis. The median overall survival was 17.5 months (95% CI, 12.5-22.5). The median progression free survival was 8.0 months (95% CI, 4.1-11.9). Conclusions : CCRT including paclitaxel in patients with locally advanced NSCLC led to an encouraging response rate and survival, but resulted in high incidence of severe pulmonary complication.