Southwest oncology group phase II trial of concurrent carboplatin, etoposide, and radiation for poor-risk stage III non-small-cell lung cancer

purpose: A phase II study was conducted by the Southwest Oncology Group (SWOG) to assess the efficacy and toxicity of concurrent carboplatin, etoposide, and thoracic radiation (XRT) in a defined population of poor-risk patients with stage III non-small-cell lung cancer (NSCLC). Patients and Methods: Patients with stage III NSCLC were eligible if they were excluded from cisplatin based protocols because of poor pulmonary or renal function, history of congestive heart failure, hearing loss, peripheral neuropathy, or weight loss. Carboplatin 200 mg/m(2) daily intravenously days 1, 3, 29, and 31 and etoposide 50 mg/m2 daily intravenously days 1 through 4 and 29 through 32 were administered. Beginning day I,XRT was delivered at 1.8 to 2.0 Gy daily to a total dose of 61 Gy. Results: Within a period of 1 year, 63 patients were registered and 60 were eligible. Patient characteristics were age 47 to 79 years, performance status 0 to 1 (82%) and 2 (18%), and stages IIIA (60%) and IIIB (40%) NSCLC. The most common grades 3 and 4 toxicities included leukopenia (50%), thrombocytopenia (23%), and esophagitis (15%), There were no treatment related deaths. The overall confirmed response rate was 29%, and median overall survival was 13 months (95% confidence interval, 11 to 14 months). The 2-year survival rate was 21%. Conclusion: This chemoradiotherapy regimen is well tolerated in poor-risk patients and yields a median survival similar to that of goad risk patients who received cisplatin-based chemoradiotherapy, This chemoradiotherapy regimen will be compared with XRT alone in poor-risk patients with stage III NSCLC in a randomised phase III trial. J Clin Oncol 16:3078-3081. (C) 1998 by American Society of Clinical Oncology.