An evaluation of concurrent chemoradiotherapy practice for locally advanced non-small cell lung cancer (NSCLC) in a single centre institution
Beardsworth, S. Coote, Joanna H Cove-Smith, Laura Harris, Maggie A Salem, Ahmed Sheikh, Hamid Y Taylor, Paul Woolf, David K
Beardsworth, S.
Coote, Joanna H
Cove-Smith, Laura
Harris, Maggie A
Salem, Ahmed
Sheikh, Hamid Y
Taylor, Paul
Woolf, David K
Citations
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Abstract
Introduction: The standard treatment for unresectable stage III non-small cell lung cancer (NSCLC) is concurrent chemoradiotherapy
(CTRT). However, only a minority of patients receive CTRT due
to poor performance status (PS) or co-morbidities. Carboplatin/
paclitaxel (CP) was introduced in our centre in 2017 as an alternative
to cisplatin/etoposide (CE) to increase the number of patients
receiving CTRT. We compare toxicity and outcomes between two
chemotherapy regimens (CE and CP) in our centre.
Methods: A retrospective audit was undertaken. Demographics,
baseline health, treatment toxicity, response, adjuvant durvalumab
use and survival were collected for patients treated with CP and CE
2018-2019. Toxicity and outcome in patients were compared (CP v
CE). Results: 106 patients were treated with concurrent CTRT 2018-2019
(CP n=20, CE n=86). Patients selected for CP mostly either had
impaired renal function (n=6 (30%)), a pre-existing hearing problem
(n=5 (25%)) or underlying cardiovascular co-morbidity (n=5 (25%)).
Baseline demographics, eGFR and proportion receiving durvalumab
were well matched (Table 1). More patients receiving CP were PS 2
(CP 15% v CE 1.2%, p=0.02). CE was associated with greater G3/G4
side effects (CP 30% v CE 60.5%, p=0.01) however CP was associated
with a higher incidence of G1/2 toxicity (p< 0.05) and chemotherapy
dose reduction/omission (CP 15% v CE 3%, p=0.05). There was no
significant difference in the progression free (13 v 17 months, p=0.3) or 1-year overall survival (65% v 79%, p=0.24) Conclusion: The introduction of CP and durvalumab have helped
facilitate increased numbers of patients receiving CTRT treatment.
CE had a higher level of G3/4 toxicity and patients treated with CP
had greater levels of G1/2 toxicity and reduced dose intensity. There
was no overall difference in survival between the groups suggesting
that both regimens should be considered in patients with stage III
NSCLC.
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Beardsworth S, Bayman N, Coote J, Cove-Smith L, Faivre-Finn C, Harris M, et al. An evaluation of concurrent chemoradiotherapy practice for locally advanced non-small cell lung cancer (NSCLC) in a single centre institution. Vol. 165, Lung Cancer. Elsevier BV; 2022. p. S51–2.