A multicenter phase II study of concurrent chemoradiotherapy with cisplatin and oral S-1, followed by surgery for locally advanced non-small-cell lung cancer

Tomoshi Tsuchiya*, Yoichi Nakamura, Nobuyuki Hayashi, Keitaro Matsumoto, Takuro Miyazaki, Katsumi Nakatomi, Minoru Fukuda, Takuya Yamasaki, Midori Shimada, Isao Sano, Hirokazu Taniguchi, Kazuhiro Tabata, Junya Fukuoka, Naoya Yamasaki, Takeshi Nagayasu, Tsutomu Tagawa

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

1 被引用数 (Scopus)

抄録

Purpose: This study was designed to evaluate the feasibility of concurrent induction chemoradiotherapy (CRT) using S-1, an oral fluoropyrimidine derivative, plus cisplatin followed by surgery in locally advanced non-small cell lung cancer (NSCLC). Patients and methods: We defined locally advanced NSCLC as pathologically proven chest wall invasion or hilar and/or mediastinal lymph node metastases by endobronchial ultrasound-guided transbronchial needle aspiration. Twenty-three patients were enrolled in this study from May 2011 to April 2014. The patients received S-1 40 mg/m2 orally twice daily on days 1 through 14 and 29 through 42, and cisplatin 60 mg/m2 was injected intravenously on days 8 and 36. The patients also underwent radiotherapy and received a total dose of 40 Gy in 20 fractions beginning on day 1. Surgical resection was performed from 4 to 6 weeks after completion of the induction treatment. Results: Of the 23 eligible patients, 18 had stage IIIA and 5 had stage IIB NSCLC. Twenty patients (87.0%) completed induction CRT and underwent surgical resection. Representative grade 3 adverse reactions were neutropenia (21.7%) and leukocytopenia (8.7%); no grade 4 adverse reactions were observed. Radiologically, 7 (30.4%) of the 23 patients achieved partial response and were therefore radiologically downstaged. Twenty patients were curatively resected. Six (26.1%) complete responses were identified and 12 cases (52.2%) were histopathologically downstaged by induction CRT. Conclusion: Concurrent induction CRT using S-1 plus cisplatin is a feasible and promising new treatment modality for locally advanced NSCLC. Evaluation of histopathological downstaging revealed sufficient anti-cancer effects for preoperative treatment. MicroAbstract: Because chemoradiotherapy (CRT) using cisplatin and S-1, an oral fluoropyrimidine, is effective for unresectable non-small cell lung cancer, the feasibility of this therapy in a neoadjuvant setting was evaluated in a multicenter phase II study. Toxicities were very mild and 87.0% of the 23 patients completed induction CRT. This protocol seems feasible and is considered an option among preoperative therapies.

本文言語英語
ページ(範囲)11-16
ページ数6
ジャーナルCancer Treatment Communications
7
DOI
出版ステータス出版済み - 2016

ASJC Scopus 主題領域

  • 腫瘍学

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