Neoadjuvant radiotherapy concurrent with weekly paclitaxel and carboplatin and followed by surgery in locally advanced non-small-cell lung cancer

Abstract

Thirty-seven patients were enrolled in a phase II study to evaluate the efficacy and toxicity of neoadjuvant radiotherapy concurrent with weekly paclitaxel and carboplatin in locoregionally advanced non-small-cell lung cancer (NSCLC). The study was also designed to evaluate the operability following concurrent chemoirradiation. The following response rates to chemoirradiation were obtained: complete response (CR) 5 of 37 (13.5%), partial response 14 of 37 (38%), stable disease 12 of 37 (32.5%) and PD 6 of 37 (16%). Twenty patients underwent surgery, and in 19 patients the tumor was totally resected. There was pathologic CR in 4 patients. Moderate/severe esophagitis developed in 16 patients (43%); hematologic toxicity was mild. There was one case of postoperative mortality. Nine patients are alive without evidence of disease at 5+ to 39+ months. Median survival is 22 months. It is concluded that neoadjuvant radiotherapy concurrent with weekly paclitaxel/carboplatin is effective and well tolerated in patients and feasible for patients with locally advanced NSCLC, allowing complete tumor resection in 56% of the cases.