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I.Z. Kiladze
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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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120P - Optimal chemotherapy regimen for concurrent chemo-radiotherapy of locally advanced unresectable stage III non-small cell lung cancer (NCSLC) (ID 597)
12:30 - 13:00 | Author(s): I.Z. Kiladze
- Abstract
Background:
Combination platinum-based chemo-radiotherapy is considered as a standard treatment of locally advanced unresectable NSCLC. The exact sequence, optimal and effective chemotherapy regimens to be used in combination with radiation therapy are all still subject of debates. Cisplatin/Etoposide (EC) and Paclitaxel/Carboplatin (PC) both demonstrated efficacy in the treatment of locally advanced unresectable NSCLC and are considered as most widely used regimens in this setting. However, there are very limited number of randomized trials comparing EC vs PC face to face.
Methods:
In our open labeled prospective study a total 52 patients were randomized (1:1) to receive 60–66 Gy intensity-modulated radiotherapy with either Etoposide 50 mg/m[2] d1-5, 29–33 and Cisplatin 50 mg/m[2] d 1, 8, 29 and 36 (ARM1) or Paclitaxel 45 mg/m[2] weekly and Carboplatin AUC = 2 mg/mL/min weekly (ARM2). Study inclusion criteria were: unresectable stage IIIA/IIIB/IIIC, NSCLC proved by pathology; treatment naïve, age 18–70; ECOG ≤ 2; no serious comorbidities; no contraindications to chemo-radiotherapy, chest CT in recent 2 weeks. The primary endpoint of the study was progression-free survival and 1year survival. Secondary endpoints were toxicity profiles of two regimens.
Results:
With median follow-up time 48 months 1-year survival was significantly higher in the EP arm than that of PC arm. Estimated difference was 27% (p value = 0.05). PFS was also higher in EP arm compared to PC arm (46% vs 5%, p value = 0.05). No significant difference in incidence of Grade >2 radiation pneumonitis and Grade >2 radiation esophagitis was observed among two arms. Incidence of Grade >3 hematologic toxicities was also similar in two groups.
Conclusions:
CP used concurrently with thoracic radiation showed better 1year survival and PFS than weekly PC. In terms of toxicity profiles these two regimens did not show statistically significant difference in our study. To determine which regimen is associated with better long term survival or PFS larger randomized studies with longer follow-up periods are needed.
Clinical trial identification:
GYOG0005
Legal entity responsible for the study:
Georgian Young Oncologists Group
Funding:
Has not received any funding
Disclosure:
All authors have declared no conflicts of interest.
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121P - Primary surgery followed by chemotherapy versus definitive concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (ID 542)
12:30 - 13:00 | Presenting Author(s): I.Z. Kiladze
- Abstract
Background:
Approximately 30–35% of patients present with locally advanced NSCLC(LAD-NSCLC) The majority of them can be treated with a combination of chemo. and radiation; however, a subset of stage III pat. are considered surgical candidates may require a modification of this plan. The purpose of this study is to compare effectiveness of primary surgery and chemotherapy versus chemoradiation in patients with LAD-NSCLC. To evaluate the survival parameters and treatment complications.
Methods:
NSCLC pat. with clinical stage IIIA and selected IIIB from 2014 to 2016 were identified retrospectively in two Institutions. Medical records reviewed. All patients were grouped in 2 treatment arms. Surgical arm: surg.+adj.chemotherapy and ChRT arm: Definitive Chemoradiotherapy.
Results:
The medical records of 75 patients (39 Surgical and 35 ChRT arm) were reviewed. More than 1/2 in both arms were with scc (51% and 61%). The type of surgery was 15 lobec- and 24 pneumonectomies with complete mediastinal l/node dissection. In CHRT arm G3-4 hematology toxicity occurred in 19pat. and 6 patients had acute non-hematology toxicity(G3). No acute G 4 radiation toxicity developed. In surg. arm only 1 severe bleeding developed and reoperation was performed. 2 patients had wound healing problems. 5 treatment related deaths occurred: 3 in the surgical arm (2 pulmonary embolus and 1 cardiac complication) and 2 patients in chemoradiation arm(2 PE). The 1-year survival rate was 69% vs 61% in surg. and ChRT arms respectively, which was not statistically significant (p = 0.4604). No difference in the 1-year survival was observed in Stage IIIA 68% vs 58% (p = 0.5627) and in Stage IIIB 72% vs 62% (p = 0.5540) between arms. No difference on median survival time (17.5 vs 16.8 m).
Conclusions:
Treatment effectiveness, complications and 1-year survival rate were equal between the surgical and ChRT arms. These results seem to indicate primary surgery as the treatment of choice for stage IIIA and selected patients with stage IIIB NSCLC, whenever a complete resection is thought to be technically feasible and the patient's conditions compatible with the extent of the planned surgery. Further results of 3- and 5-year survival rates are awaited.
Clinical trial identification:
GYO LAD-NSCLC 002
Legal entity responsible for the study:
Georgian Group of Young Oncology
Funding:
Has not received any funding
Disclosure:
All authors have declared no conflicts of interest.
