Multinational randomized phase III trial with or without consolidation chemotherapy using docetaxel and cisplatin after concurrent chemoradiation in inoperable stage III non-small-cell lung cancer: KCSG-LU05-04

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Ahn, Jin Seok; Ahn, Yong Chan; Kim, Joo-Hang; Lee, Chang Geol; Cho, Eun Kyung; Lee, Kyu Chan; Chen, Ming; Kim, Dong-Wan; Kim, Hoon-Kyo; Min, Young Joo; Kang, Jin-Hyoung; Choi, Jin-Hyuck; Kim, Sang-We; Zhu, Guangying; Wu, Yi-Long; Kim, Sung Rok; Lee, Kyung Hee; Song, Hong Suk; Choi, Yoon-La; Sun, Jong-Mu; Jung, Sin-Ho; Ahn, Myung-Ju; Park, Keunchil

Issue Date
American Society of Clinical Oncology
Journal of Clinical Oncology, Vol.33 No.24, pp.2660-2666
Purpose To determine the efficacy of consolidation chemotherapy (CC) with docetaxel and cisplatin (DP) after concurrent chemoradiotherapy (CCRT) with the same agents in locally advanced non-small-cell lung cancer (LA-NSCLC). Patient and Methods Patients were randomly assigned to either CCRT alone (observation arm) or CCRT followed by CC (consolidation arm). CCRT with docetaxel (20 mg/m(2)) and cisplatin (20 mg/m(2)) was administered every week for 6 weeks with a total dose of 66 Gy of thoracic radiotherapy in 33 fractions. In the consolidation arm, patients were further treated with three cycles of DP (35 mg/m(2) each on days 1 and 8, every 3 weeks). The primary end point was 40% improvement in progression-free survival (PFS) compared with observation. Results From October 2005 to April 2011, 437 patients were randomly assigned. Seventeen patients did not start CCRT as a result of consent withdrawal or ineligibility reasons after random assignment, leaving 420 patients for this analysis (n = 211 for observation; n = 209 for consolidation). Patient characteristics were similar in both arms. In the consolidation arm, 143 patients (68%) received CC, of whom 88 (62%) completed three planned cycles. The median PFS was 8.1 months in the observation arm and 9.1 months in the consolidation arm (hazard ratio, 0.91; 95% CI, 0.73 to 1.12; P = .36). Median overall survival times were 20.6 and 21.8 months in the observation and consolidation arms, respectively (HR, 0.91; 95% CI, 0.72 to 1.25; P = .44). Conclusion CC with DP after CCRT with weekly DP in LA-NSCLC failed to further prolong PFS. CCRT alone should remain the standard of care. (C) 2015 by American Society of Clinical Oncology
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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