An evaluation of concurrent chemoradiotherapy practice for locally advanced non-small cell lung cancer (NSCLC) in a single centre institution
Bayman, Neil A
Coote, Joanna H
Harris, Maggie A
Sheikh, Hamid Y
Woolf, David K
AffiliationFaculty of Biology, Medicine and Health, University of Manchester, Manchester,
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AbstractIntroduction: 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.
CitationBeardsworth 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.
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