Clinical investigation of weekly cisplatin and vinorelbine with concurrent radiation therapy for locally advanced non-small cell lung cancer

Concurrent combination therapy with chemotherapy (cisplatin (CDDP) and vinorelbine (VNR)) and thoracic radiotherapy was administered to patients with unresectable locally advanced non-small cell lung cancer. The subjects were 19 patients with stage III non-small cell lung cancer, performance status (PS) 0-1. They were able to undergo thoracic radiotherapy, had not received previous therapy, and had maintained main organ functions. CDDP (40 mg/m2) and VNR (20 mg/m2) were administered on days 1, 8, 22, and 29, and thoracic radiotherapy was performed every day except for those on which chemotherapy was conducted, 5 days a week at 2 Gy/day (total: 60 Gy). Four subjects were stage IIIA, 15 were stage IIIB, and their ages ranged from 42 to 75 years (median age: 65 years). The subjects were 18 males and 1 female, and concerning their histological types, 12, 5, and 2 were diagnosed squamous cell, adeno- and adenosquamous carcinoma, respectively. Regarding the therapeutic efficacy, 0, 14, and 5 subjects were clinically CR, cPR, and cSD, respectively, and their response rate was 73.7%. The median survival time was 27.2 months, and the one-year survival rate was 71.2%. Concerning ≥ grade 3 adverse effects, 14 and 12 cases had leukocytopenia and neutropenia, respectively. However, no esophagitis was observed, and only one case experienced ≥ grade 3 nausea and vomiting. Radiation pneumonitis (≥ grade 3) was observed in one case, but there was no severe liver or renal dysfunction, and no treatment-related death. It was suggested that this treatment reduces the occurrence of renal toxicity and digestive symptoms, and that a marked antitumor effect can be expected from its administration. (author)