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U. Yilmaz



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    P1.24 - Poster Session 1 - Clinical Care (ID 146)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P1.24-015 - Chemoradiotherapy-associated myelosuppression: Analysis of risk factors for patients with non-small cell lung cancer (ID 1298)

      09:30 - 16:30  |  Author(s): U. Yilmaz

      • Abstract

      Background
      Concurrent chemoradiotherapy (CRT) is standard treatment for patients with stage III non–small cell lung cancer (NSCLC). Myelosuppression can be a significant problem in concurrent CRT, but its risk factors remain largely unkown. The aim of the present study was to assess clinical and biological parameters obtained before concurrent CRT to define the risk factors for myelosuppression in patients with locally advanced NSCLC.

      Methods
      We retrospectively analyzed 81 patients with NSCLC who received concurrent platinum-based chemoradiotherapy between January 2008 and December 2012. A total of 78 patients (96.2%) received etoposide (50 mg/m2, intravenously (IV) on days 1-5, 29-33) plus cisplatin (50 mg/m2, IV, on days 1,8,29, and 36) and 3 patients (3.8%) treated docetaxel (20 mg/m2/w, IV, on weeks 1-8) plus cisplatin (20 mg/m2/w, IV, on weeks 1-8) concurrently with thoracic radiotherapy to a total dose of 40-66.6 Gy. The risk factors were examined for their association with myelosupression (grade 3 or 4 leukopenia, neutropenia, thrombocytopenia or anemia) by logistic regression analysis.

      Results
      Grade 3 or higher neutropenia, leukopenia, thrombocytopenia, or anemia occurred in 51.8, 53.0, 8.6, and 7.4 % of the patients, respectively. Multivariate analysis revealed that the risk factors for neutropenia were performance status (odds ratio [OR] , 3,196 ; p=0,032; 95 % confidence interval [CI], 1,104-9,524), white blood cell count (OR, 3,250; p=0,023; 95% CI,1,173-9009 ) and pretreatment creatinine level (OR, 3,325; p=0,018; 95% CI,1,228 - 8,999 ). On multivariate analysis, white blood cell count (OR, 3,311; p=0,027; 95% CI, 1,148-9545 ) was found as significant risk factor for CRT-induced leukopenia. No significant association was found between patient’s characteristics and anemia or thrombocytopenia

      Conclusion
      This information on grade 3-4 neutropenia and leukopenia is considered to contribute significantly to its safe and effective use of concurrent chemoradiotherapy for treatment of locally advanced NSCLC.

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    P3.09 - Poster Session 3 - Combined Modality (ID 214)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Combined Modality
    • Presentations: 1
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      P3.09-014 - Concurrent chemoradiotherapy for patients with unresectable stage III non-small cell lung carcinoma; A real-life experience (ID 2220)

      09:30 - 16:30  |  Author(s): U. Yilmaz

      • Abstract

      Background
      Investigators from the Hoosier Oncology Group reported that there was no survival advantage but significant toxicity from the addition of docetaxel consolidation to immediate radiation and concurrent cisplatin (P)–etoposide (E) for treatment in patients with unresectable stage III non-small-cell lung carcinoma (NSCLC). Concurrent chemoradiotherapy alone is standard treatment for fit patients in this group. The aim of this prospective study is to investigate the survival rates of standard treatment for these patients in a real-life.

      Methods
      Eligible patients had unresectable stage IIIA or IIIB NSCLC, baseline performance status of 0 to 1, less than 5% weight loss and adequate organ function. Patients received P 50 mg/m2 intravenously (IV) on days 1, 8, 29, and 36 and E 50 mg/m2 IV on days 1-5 and 29-33 concurrently with chest XRT to 63.00 Gy (1.8 Gy per fraction and 5 fractions per week).

      Results
      From January 2008 until December 2010, 59 patients were entered into the trial, 57 were evaluated. Patient characteristics were as follows: 94,7% male; median age, 56 years; 40,3% stage IIIA; and 59,7% stage IIIB; 64,9% squamous cell carcinoma, 17,5% adenocarcinoma. Objective response rate was 61,4% (complete response 19,3%). Grade 4 neutropenia was the most common toxicity (35,1%). 19,3% of patients experienced grade 2-3 pulmonary- late toxicity. 44 patients have died. 12,2% of patients had febrile neutropenia. One patient died due to renal toxicity. With a median follow-up time of 18 months, median progression-free survival (PFS) was 10,5 months, median overall survival (OS) was 18 months (11,7 to 24,2, 95% confidence interval), and two-, 3- and 4-year OS rates were 36,1%, 23,2%, and 16,9%, respectively. Two-, 3- and 4-year PFS rates were 17,4%, 13,2%, and 9,9%, respectively.

      Conclusion
      The survival rates in real-life studies as the current study can be expected to be mildly shorter than those in controlled clinical trials.