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Compared with radiotherapy concurrent chemoradiotherapy with nedaplatin-based versus cisplatin-based regimen in locally advanced non-small cell lung cancer
Zhang Tao, Bi Nan, Zhou Zongmei, Chen Dongfu, Xiao Zefen, Feng Qinfu, Liang Jun, Lyu Jima, Wang Xin, Deng Lei, Wang Wenqing, Wang Luhua
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences ( CAMS ) and Peking Union Medical College ( PUMC),Beijing 100021,China
AbstractObjective To compare the clinical efficacy and toxicity between nedaplatin-and cisplatin-based regimens in patients with unresectable locally advanced non-small cell lung cancer (NSCLC) receiving concurrent chemoradiotherapy. Methods From January,2015 to December,2016, patients with unresectable locally advanced NSCLC receiving concurrent chemoradiotherapy were included in this study. Patients received thoracic radiotherapy (RT) combined with nedaplatin-based concurrent chemotherapy were enrolled in the nedaplatin group (n=38).Those treated with thoracic RT combined with cisplatin-based chemotherapy were allocated into the cisplatin group (n=84).The chemotherapy regime consisted of platinumin combination with paclitaxel or etoposide. Platinum combined with pemetrexed was adopted in patients with adenocarcinoma. Overall, the median age was 58 years old. Most of the patients were male (86.1%),77.0% of them had a history of smoking and 63.9% of the patients were pathologically diagnosed with squamous cell carcinoma. Besides,59.0% of the patients had ⅢB NSCLC. Results In the nedaplatin and cisplatin groups,the overall response rate (ORR) was 79% and 86%,and the disease control rate was 94% and 94%.The median follow-up time was 20 months. In the nedaplatin group, the 1-and 2-year PFS was 49% and 23%,and 67% and 39% in the cisplatin group (P=0.160).In the nedaplatin group, the 1-and 2-year OS was 91% and 72%,and 89% and 68% in the cisplatin group (P=0.552).Nine patients (24%) had ≥grade 3 adverse events in the nedaplatin group and 25 patients (30%) in the cisplatin group (P=0.488).No statistical significance was found in radiation-induced esophagitis, bone marrow suppression and gastrointestinal toxicity between two groups. One patient in the nedaplatin group presented with grade 3 radiation-induced pneumonitis and 2 patients died of radiation-induced pneumonitis in the cisplatin group. Conclusions Thoracic radiotherapy combined with nedaplatin-based chemotherapy is a promising option for patients with unresectable locally NSCLC. Compared with the cisplatin-based chemotherapy, nedaplatin-based regime yields equivalent clinical efficacy and less adverse events, especially suitable for the elderly patients with poor tolerance.
Fund:Central Public-Interest Scientific Institution Basal Research Fund 805184 Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2017-I2M-1-009)
Corresponding Authors:
Bi Nan,Email:binan_email@163.com
Cite this article:
Zhang Tao,Bi Nan,Zhou Zongmei et al. Compared with radiotherapy concurrent chemoradiotherapy with nedaplatin-based versus cisplatin-based regimen in locally advanced non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2019, 28(5): 334-338.
Zhang Tao,Bi Nan,Zhou Zongmei et al. Compared with radiotherapy concurrent chemoradiotherapy with nedaplatin-based versus cisplatin-based regimen in locally advanced non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2019, 28(5): 334-338.
[1] ShukuyaT,YamanakaT,SetoT,etal. Nedaplatin plus docetaxel versus cisplatin plus docetaxel for advanced orrelapsed squamous cell carcinoma of the lung (WJOG5208L):a randomised,open-label,phase 3 trial[J].Lancet Oncol,2015,16(16):1630-1638.DOI:10.1016/S1470-2045(15)00305-8. [2] Lu S,ChenZ,HuC,etal. Nedaplatin plus docetaxel versus cisplatin plus docetaxel asfirst-line chemotherapy for advanced squamous cell carcinoma of the lung-Amulticenter,open-label,randomized,phaseⅢ trial[J].J Thorac Oncol,2018,pii:S1556-0864(18)30782-2.DOI:10.1016/j.jtho.2018.07.006. [3] Tang LQ,ChenDP,GuoL,etal. Concurrent chemoradiotherapy with nedaplatin versus cisplatin in stage Ⅱ-IVB nasopharyngeal carcinoma:an open-label,non-inferiority,randomised phase 3 trial[J].LancetOncol,2018,19(4):461-473.DOI:10.1016/S1470-2045(18)30104-9. [4] Hasegawa Y,TakanashiS,OkuderaK,etal. Weekly paclitaxel and nedaplatin with concurrent radiotherapy for locally advanced non-small-cell lung cancer:aphase Ⅰ/Ⅱ study[J].Jpn J Clin Oncol,2004,34(11):647-653.DOI:10.1093/jjco/hyh119. [5] SekineI,SumiM,ItoY,etal. PhaseⅠ study of cisplatin analogue nedaplatin,paclitaxel,and thoracic radiotherapy for unresectable stage Ⅲ non-small cell lung cancer[J].Jpn J Clin Oncol,2007,37(3):175-180.DOI:10.1093/jjco/hym008. [6] Lu Y,GuW,DengJ,etal. A phase Ⅰ study of nedaplatin,pemetrexed and thoracic intensity-modulated radiotherapy for inoperable stage Ⅲ lungadenocarcinoma[J].BMC Cancer,2016,16(1):775.DOI:10.1186/s12885-016-2800-5. [7] Non-small cell lung cancer collaborative group. Chemotherapy in non-small cell lung cancer:a meta-analysis using updated dataon individual patients from 52 randomised clinical trials[J].BMJ,1995,311(7010):899-909. [8] Bi N,WangL.Superiority of concomitant chemoradiation over sequentialchemoradiation in inoperable,locally advanced non-small cell lung cancer:challenges in the selection of appropriate chemotherapy[J].SeminRadiat Oncol,2015,25(2):122-132.DOI:10.1016/j.semradonc.2014.11.003. [9] OshitaF,OheM,HondaT,etal. PhaseⅡ study of nedaplatin and irinotecan with concurrentthoracic radiotherapy in patients with locally advanced non-small-cell lungcancer[J].Br J Cancer,2010,103(9):1325-1330.DOI:10.1038/sj.bjc.6605875.
2019, Vol. 28 
