In:
Oncology, S. Karger AG, Vol. 64, No. 1 ( 2003), p. 18-24
Abstract:
〈 i 〉 Objectives: 〈 /i 〉 Patients with non-small-cell lung cancer (NSCLC) and malignant pleural effusion (MPE) are difficult to manage clinically and have a short life expectancy. In this pilot study, we designed a protocol of combined intrapleural (i.p.) and intravenous (i.v.) chemotherapy and pulmonary irradiation to enhance local as well as systemic control of the disease. 〈 i 〉 Methods: 〈 /i 〉 From April 1998 to April 2000, 27 patients with NSCLC and symptomatic MPE were eligible for the study. Patients received pre-radiation chemotherapy (cisplatin 60 mg/m 〈 sup 〉 2 〈 /sup 〉 i.p. on day 1; gemcitabine 1,000 mg/m 〈 sup 〉 2 〈 /sup 〉 i.v. on days 1, 8, and 15, q4week × 3) after surgical implantation of i.p. and i.v. port-A, followed by radiotherapy (7,020 cGy/39fr), and, finally, post-radiation chemotherapy (docetaxel 60 mg/m 〈 sup 〉 2 〈 /sup 〉 q3week × 3–6 i.v.). 〈 i 〉 Results: 〈 /i 〉 Grade 1/2 nausea/vomiting and impaired renal function were more common from pre-radiation than post-radiation chemotherapy; however, grade 3/4 toxicities from pre-radiation chemotherapy were minimal. Conversely, grade 3/4 leukopenia and grade 1/2 alopecia, diarrhea, elevation of SGOT/SGPT, and sensory impairment were more common following post-radiation chemotherapy. Only two patients experienced recurrence of pleural effusion. The overall response rate was 55% with 7% complete remission, 48% partial remission, 22% stable disease, and 22% progressive disease. The median failure-free and overall survival was 8 and 16 months, respectively. The one-year survival rate was 63% (95% confidence interval, 45–80%). 〈 i 〉 Conclusions: 〈 /i 〉 We conclude that the combination of i.p. and i.v. chemotherapy and pulmonary irradiation is feasible and should be tested in a larger clinical trial to determine whether survival can be improved for this cohort of patients.
Type of Medium:
Online Resource
ISSN:
0030-2414
,
1423-0232
Language:
English
Publisher:
S. Karger AG
Publication Date:
2003
detail.hit.zdb_id:
1483096-6
detail.hit.zdb_id:
250101-6
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