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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
118P - A comparative study of sequential chemoradiation vs concurrent chemoradiation vs concurrent chemoradiation followed by consolidation chemotherapy in unresectable NSCLC (ID 200)
12:30 - 13:00 | Presenting Author(s): A. Datta
To compare the Response Rates, acute and late toxicities and Time to Progression (TTP) in the 3 arms.
Patients with unresectable NSCLC were prospectively analysed from August 2011 – September 2013. They were randomized to 3 arms of Sequential Chemoradiation (ARM A), Concurrent Chemoradiation followed by consolidation chemotherapy (ARM B) and Concurrent Chemoradiation (ARM C). Arm A received 2 cycles induction while Arm B received 2 cycles consolidation chemotherapy. Arm C was the Control arm. Drugs used were Paclitaxel (175 mg/m)/Carboplatin (AUC 5). Their dose in concurrent setting were 45 mg/m and AUC 2 respectively. The dose of radiation used was 60 Gy in 30 fractions. Response Rate was assessed using RECIST v1.1 criteria while acute and late toxicities were assessed by RTOG/EORTC (skin, upper GI, Dysphagia) and CTCAE v4.0 (dyspnoea, haematological and peripheral neuropathy) criteria. For TTP Kaplan Meier survival analysis with Log rank was used for inter-treatment comparisons.
72 patients (male = 68, female = 4) were randomised in the 3 arms in 1:1:1 allocation of whom 64 patients (all males) were available for analysis (Arm A = 20, Arm B = 21, Arm C = 23). All the 3 arms were comparable in their baseline parameters. Chi Square test analysis showed non-significant statistical difference in response rates between the 3 arms. TTP was superior with median PFS of 7 months (95% C.I. 5.2mths, 8.8 months) in Arm C (Concurrent Chemoradiation arm). Grade 2 & 3 acute skin toxicities in Arms B (33% & 9.5%) & C (21.7% & 4.3%) were more (p < 0.001). Grade 2 & 3 upper GI toxicity in Arms B (57.1% & 28.6%) & C (87.0% & 13%) were higher (p < 0.001). Grade 2 & 3 Haematological toxicity was more (p < 0.001) in Arms B (42.9% & 57.1%) & C (52.2% & 47.8%). Grade 2 & 3 Dysphagia was more (p < 0.001) in Arms B (57.1% & 28.6%) & C (87% & 13%). Peripheral neuropathy was higher in Arms B & C (p < 0.001) with Arm C having the maximum Grade 2 neuropathy (78.3%). There was no difference among the late skin toxicity among the 3 arms (p = 0.869).
There was no difference in the response rates across the 3 arms. The Concurrent Chemoradiation arm had the maximum Time to progression with maximum acute toxicities.
Clinical trial identification:
Legal entity responsible for the study:
IPGMER and SSKM Hospital
Has not received any funding
All authors have declared no conflicts of interest.