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dc.contributor.authorSheikh, Hamid Y
dc.contributor.authorColaco, Rovel J
dc.contributor.authorLorigan, Paul C
dc.contributor.authorBlackhall, Fiona H
dc.contributor.authorCalifano, Raffaele
dc.contributor.authorAshcroft, Linda
dc.contributor.authorTaylor, Paul
dc.contributor.authorThatcher, Nick
dc.contributor.authorFaivre-Finn, Corinne
dc.date.accessioned2012-05-01T11:37:45Z
dc.date.available2012-05-01T11:37:45Z
dc.date.issued2011-10
dc.identifier.citationUse of G-CSF during concurrent chemotherapy and thoracic radiotherapy in patients with limited-stage small-cell lung cancer safety data from a phase II trial. 2011, 74 (1):75-9 Lung Canceren_GB
dc.identifier.issn1872-8332
dc.identifier.pmid21353720
dc.identifier.doi10.1016/j.lungcan.2011.01.020
dc.identifier.urihttp://hdl.handle.net/10541/221355
dc.description.abstractThere is paucity of data in the literature regarding the safety of combining granulocyte colony stimulating factor (G-CSF) during chemo-radiotherapy (CTRT) in lung cancer patients. The ASCO 2006 recommendations advise against use of CSFs during concomitant mediastinal CTRT. The only randomised study evaluating CSFs in this context showed significant increase in grade 3/4 thrombocytopenia and an excess of pulmonary toxic deaths. In the context of a phase II trial, 38 patients with limited-stage small cell lung cancer were randomised to receive once-daily (66 Gy in 33 fractions) or twice-daily (45 Gy in 30 fractions) radiotherapy. Radiotherapy (RT) was given concurrently with cisplatin and etoposide. G-CSF was given as primary or secondary prophylaxis or as a therapeutic measure during an episode of febrile neutropenia according to local protocols. Common terminology criteria for adverse events (CTCAE) v3.0 was used to record toxicity. Thirteen (34%) of 38 patients received G-CSF concurrently with RT. With a median follow-up of 16.9 months, there were no treatment related deaths reported. Seven (54%) patients experienced grade 3/4 thrombocytopenia and 5 (38%) experienced grade 3/4 anaemia. Thirty-one percent required platelet transfusions. No episodes of bleeding were observed. There were no cases of grade 3/4 acute pneumonitis. These data suggests that with modern three-dimensional (3D) conformal RT, G-CSF administration concurrently with CTRT does not result in the increase risk of pulmonary toxicity, but does increase the risk of thrombocytopenia. Whether the risks of thrombocytopenia are outweighed by the outcome of timely early concurrent CTRT is being evaluated prospectively in the ongoing phase III CONVERT trial (NCT00433563) in which G-CSF is permitted during thoracic irradiation.
dc.language.isoenen
dc.rightsArchived with thanks to Lung cancer (Amsterdam, Netherlands)en_GB
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAnemia
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols
dc.subject.meshChemoradiotherapy
dc.subject.meshCisplatin
dc.subject.meshDisease Progression
dc.subject.meshEtoposide
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshGranulocyte Colony-Stimulating Factor
dc.subject.meshHumans
dc.subject.meshLung Neoplasms
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNeoplasm Staging
dc.subject.meshPlatelet Transfusion
dc.subject.meshSmall Cell Lung Carcinoma
dc.subject.meshSurvival Analysis
dc.subject.meshThrombocytopenia
dc.titleUse of G-CSF during concurrent chemotherapy and thoracic radiotherapy in patients with limited-stage small-cell lung cancer safety data from a phase II trial.en
dc.typeArticleen
dc.contributor.departmentDept of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK.en_GB
dc.identifier.journalLung Canceren_GB
html.description.abstractThere is paucity of data in the literature regarding the safety of combining granulocyte colony stimulating factor (G-CSF) during chemo-radiotherapy (CTRT) in lung cancer patients. The ASCO 2006 recommendations advise against use of CSFs during concomitant mediastinal CTRT. The only randomised study evaluating CSFs in this context showed significant increase in grade 3/4 thrombocytopenia and an excess of pulmonary toxic deaths. In the context of a phase II trial, 38 patients with limited-stage small cell lung cancer were randomised to receive once-daily (66 Gy in 33 fractions) or twice-daily (45 Gy in 30 fractions) radiotherapy. Radiotherapy (RT) was given concurrently with cisplatin and etoposide. G-CSF was given as primary or secondary prophylaxis or as a therapeutic measure during an episode of febrile neutropenia according to local protocols. Common terminology criteria for adverse events (CTCAE) v3.0 was used to record toxicity. Thirteen (34%) of 38 patients received G-CSF concurrently with RT. With a median follow-up of 16.9 months, there were no treatment related deaths reported. Seven (54%) patients experienced grade 3/4 thrombocytopenia and 5 (38%) experienced grade 3/4 anaemia. Thirty-one percent required platelet transfusions. No episodes of bleeding were observed. There were no cases of grade 3/4 acute pneumonitis. These data suggests that with modern three-dimensional (3D) conformal RT, G-CSF administration concurrently with CTRT does not result in the increase risk of pulmonary toxicity, but does increase the risk of thrombocytopenia. Whether the risks of thrombocytopenia are outweighed by the outcome of timely early concurrent CTRT is being evaluated prospectively in the ongoing phase III CONVERT trial (NCT00433563) in which G-CSF is permitted during thoracic irradiation.


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