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M. Kacharava

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • 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): M. Kacharava

      • Abstract
      • Slides

      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.

      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.

      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.

      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:

      Legal entity responsible for the study:
      Georgian Young Oncologists Group

      Has not received any funding

      All authors have declared no conflicts of interest.

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