Treatment of locally advanced Stage IIIA-B non small cell lung cancer with paclitaxel and carboplatin administered weekly in combination with radiation therapy produces some of the most promising survival rates reported in patients with locally advanced non small cell lung cancer.
Combination chemotherapy and radiation therapy is a standard treatment of locally advanced non small cell lung cancer. The results of delivering paclitaxel and carbolplatin administered every week simultaneous with radiation therapy for a total of 7 weeks followed by higher dose paclitaxel and carboplatin chemotherapy to patients with stage IIIA-B locally advanced non small cell cancer was recently reported. It had been previously determined that administering paclitaxel and carboplatin chemotherapy on a weekly basis was tolerated by patients, may allow for a greater total drug delivery and was associated with different side effects than traditional approaches of giving chemotherapy at 3 week intervals.
Side effects associated with delivery of the weekly therapy included significant neutropenia in 37% of patients and lymphopenia in almost 50% of patients. The major toxicity experienced by patients, however, was esophagitis which was severe in approximately 50% of patients resulting in stricture or scarring of the esophagus and requiring additional treatment intervention in 2 patients. In this clinical trial, approximately 75% of patients experience a significant reduction or response in their tumor and the average duration of survival for patients was approximately 21 months. Fifty-six percent of patients survived 1 year and 38% 2 years from initiation of treatment. Thirty-five percent of patients were alive 2 years from treatment without evidence of disease recurrence. Although this treatment approach was associated with significant esophagitis, the 2 year progression-free survival rate of 35% is as good as any treatment approach reported at the time of this publication. (Journal of Clinical Oncology, Vol 16, No 10, pp 3316-3322, 1998)
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