Multiinstitutional phase II trial of paclitaxel, carboplatin, and concurrent radiation therapy for locally advanced non-small-cell lung cancer

Purpose: Combined modality therapy for non-small-cell lung cancer (NSCLC) has produced promising results, A multiinstitutional phase II clinical trial was conducted to evaluate the activity and toxicity of paclitaxel, carboplatin, and concurrent radiation therapy on patients with locally advanced NSCLC, Patients and Methods: Forty previously untreated patients with inoperable locally advanced NSCLC entered onto a phase II study from March 1995 to December 1996. On an outpatient basis for 7 weeks, patients received paclitaxel 50 mg/m(2) weekly over 1 hour; carboplatin at (area under the curve) AUC 2 weekly; and radiation therapy of 66 Gy in 33 fractions. After chemoradiation therapy, patients received an additional two cycles of paclitaxel 200 mg/m(2) over 3 hours and carboplatin at AUC 6 every 3 weeks. Results: Thirty-nine patients were eligible for the study. The survival rates at 1 2 months were 56.3%, and at 24 months, 38.3%, with a median overall survival of 20.5 months. The progression-free survival rates at 12 months were 43.6%, and at 24 months, 34.7%, with a median progression free survival of 9.0 months. Two patients did not receive more than 2 weeks of concurrent chemoradiotherapy and were not assessable for toxicity and response. The overall response rate (partial plus complete response) of 37 assessable patients was 75.7%, The major toxicity was esophagitis. Seventeen patients (46%) developed grade 3 or 4 esophagitis. However, only two patients developed late esophageal toxicity with stricture at 3 and 6 months posttreatment. Conclusion: Combined modality therapy with paclitaxel, carboplatin, and radiation is ct promising treatment for locally advanced NSCLC that has a high response rare and acceptable toxicity and survival rates. A randomized trial will be necessary to fully evaluate the usefulness of these findings. (C) 1998 by American Society of Clinical Oncology.