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SCLC and early stage NSCLC (ID 62)
- Event: ELCC 2017
- Type: Proffered Paper session
- Presentations: 1
LBA2_PR - Use of G-CSF and prophylactic antibiotics with concurrent chemo-radiotherapy in limited-stage small cell lung cancer: Results from the Phase III CONVERT trial (ID 501)
09:00 - 10:30 | Author(s): A. Bezjak
Concurrent chemo-radiotherapy (CTRT) is the optimal treatment for limited-stage small cell lung cancer. The use of granulocyte colony stimulating-factor (G-CSF) in this context is controversial and its routine use is not recommended after a report of higher toxicity but the safety data is scarce. The use of prophylactic antibiotics is also not standardised.
In a phase 3 trial, 547 patients (pts) were randomised between once-daily RT (66Gy 33 fractions) or twice-daily (45Gy 30 fractions) with chemotherapy (cisplatin/etoposide). The use of prophylactic G-CSF and antibiotics was permitted.
33% of pts received at least 1 cycle of prophylactic G-CSF and 41% received prophylactic and/or therapeutic G-CSF. Its use increased from 11% at cycle 1 to 27% at cycle 4. Prophylactic antibiotics were used in 48% of pts but its use decreased from 41% to 20%. The use of antibiotics and/or G-CSF was similar in both arms. The incidence of grade 3/4 thrombocytopenia was higher in pts with G-CSF (29.4% vs. 13%; p
The use of G-CSF with modern radiotherapy techniques during CTRT does not result in an increased risk of severe acute esophagitis or pneumonitis. Despite an increased incidence of severe thrombocytopenia and anaemia, the use of G-CSF was not detrimental in PFS or OS.
Clinical trial identification:
ISRCTN91927162 / NCT00433563
Legal entity responsible for the study:
The Christie NHS Foundation Trust
The Christie NHS FT, Cancer Research UK, EORTC, GECP, GFPC, IFCT.
All authors have declared no conflicts of interest.
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