Sequential chemoradiation therapy with @entity1206 , XXXX , and @entity900 in stage IIIB @entity1149 : a phase II study.

@entity1 @entity137 @entity82 @entity55 @entity5 @entity1149 @entity900 @entity1514 @entity1206 @entity1282 @entity1260
Meta-analysis has demonstrated survival benefit for @entity1 with stage IIIB @entity1149 treated with sequential chemoradiotherapy versus radiotherapy alone. The introduction of chemotherapy as part of a multimodality approach has improved the outcome in this poor prognostic subset of @entity5 @entity1 . In the present phase II study we evaluated the safety and activity of a new @entity900 -based three-drug regimen consisting of @entity1206 / @entity1260 / @entity900 (VIP) followed by curative @entity1514 irradiation in 28 @entity1 with stage IIIB @entity1149 . @entity1 received @entity1206 25 mg/m2 on days 1 and 8, @entity1260 3 g/m2 on day 1 (with mesna), and @entity900 80 mg/m2 on day 1 every 3 weeks. After three courses of induction chemotherapy, @entity1 with objective response or stable disease were eligible for @entity1514 radiotherapy. Twenty-six of the 28 @entity1 received at least three courses of chemotherapy and were evaluable for response. The response rate to induction VIP was 58% (15 of 26 @entity1 ; one complete response and 14 partial responses). Seven @entity1 had disease stabilization and four progressed during chemotherapy. Radiation treatment started from 4 to 6 weeks after the end of chemotherapy with standard fractionation (200 cGy/day, 5 fractions/wk/6 wk). Eighteen of 22 @entity1 started @entity1514 irradiation; 14 completed the treatment plan, reaching the total dose of 60 Gy. The most relevant acute and late @entity137 of radiotherapy were grade 3 @entity1282 and @entity55 in two @entity1 and grade 3 lung @entity82 in six @entity1 . By comparing the @entity5 volumes before and after radiation treatment we observed six clinical remissions, three stable diseases, and five local progressions. The first site of recurrence was local in 10 of 18 @entity1 (56%), distant in seven @entity1 (38.8%), and both local and distant in one @entity1 . Median progression-free survival and overall survival for the @entity1 treated with radiotherapy (18 @entity1 ) were 14 months (range, 4 to 36 months) and 26 months (range, 7 to 54+ months), respectively; the 1- and 2-year survival rates were 61% and 52%. Curative @entity1514 radiotherapy was well tolerated after VIP induction chemotherapy; it reduced residual @entity5 volume in six @entity1 .
