Docetaxel (D) and Cisplatin (C) Induction Chemotherapy Followed by Concurrent Thoracic Radiotherapy (TRT) and Biweekly D and C for Stage III Non-Small Cell Lung Cancer (NSCLC): A Galician Lung Cancer Group Study.

7090 Background: Concurrent chemoradiation is recommended as the evidence-based approach for the management of patients (p) with locally advanced NSCLC and a good performance status. The aim of our study was to evaluate the feasibility of induction chemotherapy with D-C followed by concurrent TRT and biweekly D-C. Methods: 85 p with locally advanced NSCLC, stage IIIAN2/IIIB (no pleural T4), were included in a phase II study consisting with three cycles of D 75 mg/m2 on day 1 and C 40 mg/m2 days 1-2 every 3 weeks and, if no surgery, then underwent concurrent TRT (60-66Gys, 180 cGys/d) with D 30 mg/m2 and C 30 mg/m2 every 2 weeks for four courses. Median follow-up: 12.6 months. Results: The p characteristics were: mean age 61 years (44-75); male/female 77/8; ECOG PS 0/1 in 25/60 p; squamous/adeno/large cell carcinoma: 51.8%/28.2%/20%; stage IIIAN2 20 p (23.5%) and stage IIIB 49 p (76.5%). 79 p were evaluable for response and 82 p for toxicity. Induction D-C response: 2 CR, 47 PR (RR 62%; CI95%:51-73), 21 SD (26.6%) and 9 PD (11.4%). 9 p underwent surgery: 1 pCR, 5 pPR, 1 pEE and 2 p unresectable. 55 p completed concurrent TRT with 8 CR, 37 PR (RR 81.8%; CI95%:71-92), 3 SD and 7 PD. The median progression-free survival (PFS) was 9 months (CI95%:8-14) and median overall survival (OS) was 18 months (CI95%:13-23). The PFS and OS at 1/2 years were 45%/20% and 64%/42% respectively. A total of 235 cycles of D-C were given (2.8 per p); main toxicities (NCI-CTC 3.0) per p grade (g) 1-2/3-4 (%) were as follows: neutropenia 10.9/25.6; anemia 30.4/3.5; nausea/vomiting 30.4/7.3; fatigue 28/0; diarrhea 17/9.7; there were ten episodes of febrile neutropenia and there was one treatment-related death. Main toxicities per p in concurrent TRT (D-C doses: 211, 3.6 per p) were: g1-2 neutropenia/anemia 12/34.4%; g1-2/3 esophagitis in 51.7/1.7% and g1-2 pneumonitis in 24.5%; there was one treatment-related death. Conclusions: Induction chemotherapy with D-C followed of concurrent TRT and biweekly D-C is a feasible treatment option for locally advanced NSCLC, showing good clinical activity and tolerability with acceptable long-term survival. No significant financial relationships to disclose.