A phase I study of split-dose cisplatin and etoposide with concurrent accelerated hyperfractionated thoracic radiotherapy in elderly patients with limited-disease small cell lung cancer

Kunio Okamoto, Isamu Okamoto, Masayuki Takeda, Shinya Kobayashi, Koji Takeda, Kiyoshi Nakamatsu, Yasumasa Nishimura, Kazuhiko Nakagawa

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Abstract

Objective: The optimal treatment for elderly patients with limited-disease small cell lung cancer has not been defined. We therefore performed a Phase I study for split-dose cisplatin plus etoposide combined with early concurrent accelerated hyperfractionated thoracic radiotherapy in elderly (70 years of age or older) patients with limited-disease small cell lung cancer. Methods: Chemotherapy consisted of cisplatin at 20 or 25 mg/m2 and etoposide at 80 mg/m2, both administered on Days 1-3 of a 28-day cycle. Radiotherapy was initiated at the onset of chemotherapy and administered at a dose of 1.5 Gy twice daily over 3 weeks up to a total dose of 45 Gy. Results: Twelve patients with a median age of 76 years (range, 70-85) were enrolled. Dose-limiting toxicities occurred in two (hyponatremia of Grade 4 or cardiac ischemia of Grade 3) of the six patients treated at dose Level 1 as well as in three (perforation of the sigmoid colon of Grade 3, febrile neutropenia of Grade 3, or hyponatremia of Grade 3) of the six patients treated at dose Level 2. The most frequent non-hematologic adverse events included anorexia, fatigue, esophagitis and pneumonitis, but most of these events were of Grade 1 or 2. Conclusions: The recommended dose for cisplatin and etoposide chemotherapy administered on Days 1-3 was determined to be 20 and 80 mg/m2, respectively. Our results indicate that split-dose cisplatin plus etoposide chemotherapy combined with early concurrent accelerated hyperfractionated thoracic radiotherapy is well tolerated by elderly patients with limited-disease small cell lung cancer.

Original languageEnglish
Article numberhyu071
Pages (from-to)743-748
Number of pages6
JournalJapanese Journal of Clinical Oncology
Volume44
Issue number8
DOIs
Publication statusPublished - 2014

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Small Cell Lung Carcinoma
Etoposide
Cisplatin
Radiotherapy
Thorax
Drug Therapy
Hyponatremia
Febrile Neutropenia
Esophagitis
Anorexia
Sigmoid Colon
Fatigue
Pneumonia
Ischemia

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research
  • Radiology Nuclear Medicine and imaging

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A phase I study of split-dose cisplatin and etoposide with concurrent accelerated hyperfractionated thoracic radiotherapy in elderly patients with limited-disease small cell lung cancer. / Okamoto, Kunio; Okamoto, Isamu; Takeda, Masayuki; Kobayashi, Shinya; Takeda, Koji; Nakamatsu, Kiyoshi; Nishimura, Yasumasa; Nakagawa, Kazuhiko.

In: Japanese Journal of Clinical Oncology, Vol. 44, No. 8, hyu071, 2014, p. 743-748.

Research output: Contribution to journalArticle

Okamoto, Kunio ; Okamoto, Isamu ; Takeda, Masayuki ; Kobayashi, Shinya ; Takeda, Koji ; Nakamatsu, Kiyoshi ; Nishimura, Yasumasa ; Nakagawa, Kazuhiko. / A phase I study of split-dose cisplatin and etoposide with concurrent accelerated hyperfractionated thoracic radiotherapy in elderly patients with limited-disease small cell lung cancer. In: Japanese Journal of Clinical Oncology. 2014 ; Vol. 44, No. 8. pp. 743-748.
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AU - Takeda, Masayuki

AU - Kobayashi, Shinya

AU - Takeda, Koji

AU - Nakamatsu, Kiyoshi

AU - Nishimura, Yasumasa

AU - Nakagawa, Kazuhiko

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N2 - Objective: The optimal treatment for elderly patients with limited-disease small cell lung cancer has not been defined. We therefore performed a Phase I study for split-dose cisplatin plus etoposide combined with early concurrent accelerated hyperfractionated thoracic radiotherapy in elderly (70 years of age or older) patients with limited-disease small cell lung cancer. Methods: Chemotherapy consisted of cisplatin at 20 or 25 mg/m2 and etoposide at 80 mg/m2, both administered on Days 1-3 of a 28-day cycle. Radiotherapy was initiated at the onset of chemotherapy and administered at a dose of 1.5 Gy twice daily over 3 weeks up to a total dose of 45 Gy. Results: Twelve patients with a median age of 76 years (range, 70-85) were enrolled. Dose-limiting toxicities occurred in two (hyponatremia of Grade 4 or cardiac ischemia of Grade 3) of the six patients treated at dose Level 1 as well as in three (perforation of the sigmoid colon of Grade 3, febrile neutropenia of Grade 3, or hyponatremia of Grade 3) of the six patients treated at dose Level 2. The most frequent non-hematologic adverse events included anorexia, fatigue, esophagitis and pneumonitis, but most of these events were of Grade 1 or 2. Conclusions: The recommended dose for cisplatin and etoposide chemotherapy administered on Days 1-3 was determined to be 20 and 80 mg/m2, respectively. Our results indicate that split-dose cisplatin plus etoposide chemotherapy combined with early concurrent accelerated hyperfractionated thoracic radiotherapy is well tolerated by elderly patients with limited-disease small cell lung cancer.

AB - Objective: The optimal treatment for elderly patients with limited-disease small cell lung cancer has not been defined. We therefore performed a Phase I study for split-dose cisplatin plus etoposide combined with early concurrent accelerated hyperfractionated thoracic radiotherapy in elderly (70 years of age or older) patients with limited-disease small cell lung cancer. Methods: Chemotherapy consisted of cisplatin at 20 or 25 mg/m2 and etoposide at 80 mg/m2, both administered on Days 1-3 of a 28-day cycle. Radiotherapy was initiated at the onset of chemotherapy and administered at a dose of 1.5 Gy twice daily over 3 weeks up to a total dose of 45 Gy. Results: Twelve patients with a median age of 76 years (range, 70-85) were enrolled. Dose-limiting toxicities occurred in two (hyponatremia of Grade 4 or cardiac ischemia of Grade 3) of the six patients treated at dose Level 1 as well as in three (perforation of the sigmoid colon of Grade 3, febrile neutropenia of Grade 3, or hyponatremia of Grade 3) of the six patients treated at dose Level 2. The most frequent non-hematologic adverse events included anorexia, fatigue, esophagitis and pneumonitis, but most of these events were of Grade 1 or 2. Conclusions: The recommended dose for cisplatin and etoposide chemotherapy administered on Days 1-3 was determined to be 20 and 80 mg/m2, respectively. Our results indicate that split-dose cisplatin plus etoposide chemotherapy combined with early concurrent accelerated hyperfractionated thoracic radiotherapy is well tolerated by elderly patients with limited-disease small cell lung cancer.

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