Phase III Study of Concurrent Versus Sequential Thoracic Radiotherapy in Combination With Cisplatin and Etoposide for Limited-Stage Small-Cell Lung Cancer: Results of the Japan Clinical Oncology Group Study 9104

• Minoru Takada

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Masahiro Fukuoka

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Masaaki Kawahara

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Takahiko Sugiura

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Akira Yokoyama

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Soichiro Yokota

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Yutaka Nishiwaki

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Koshiro Watanabe

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Kazumasa Noda

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Tomohide Tamura

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Haruhiko Fukuda

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

• Nagahiro Saijo

  From the Osaka Prefectural Habikino Hospital, Osaka City General Medical Center, Kinki National Hospital for Chest Disease, and National Toneyama Hospital for Chest Disease, Osaka; Aichi Cancer Center, Aichi; Niigata Cancer Center Hospital, Niigata; National Cancer Center Hospital East, Chiba; Yokohama Municipal Citizen’s Hospital and Kanagawa Cancer Center, Kanagawa; and National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.

抄録

PURPOSE: To evaluate the optimal timing for thoracic radiotherapy (TRT) in limited-stage small-cell lung cancer (LS-SCLC), the Lung Cancer Study Group of the Japan Clinical Oncology Group conducted a phase III study in which patients were randomized to sequential TRT or concurrent TRT. PATIENTS AND METHODS: We treated 231 patients with LS-SCLC. TRT consisted of 45 Gy over 3 weeks (1.5 Gy twice daily), and the patients were randomly assigned to receive either sequential or concurrent TRT. All patients received four cycles of cisplatin plus etoposide every 3 weeks (sequential arm) or 4 weeks (concurrent arm). TRT was begun on day 2 of the first cycle of chemotherapy in the concurrent arm and after the fourth cycle in the sequential arm. RESULTS: Concurrent radiotherapy yielded better survival than sequential radiotherapy (P = .097 by log-rank test). The median survival time was 19.7 months in the sequential arm versus 27.2 months in the concurrent arm. The 2-, 3-, and 5-year survival rates for patients who received sequential radiotherapy were 35.1%, 20.2%, and 18.3%, respectively, as opposed to 54.4%, 29.8% and 23.7%, respectively, for the patients who received concurrent radiotherapy. Hematologic toxicity was more severe in the concurrent arm. However, severe esophagitis was infrequent in both arms, occurring in 9% of the patients in the concurrent arm and 4% in the sequential arm. CONCLUSION: This study strongly suggests that cisplatin plus etoposide and concurrent radiotherapy is more effective for the treatment of LS-SCLC than cisplatin plus etoposide and sequential radiotherapy.

収録刊行物

• Journal of Clinical Oncology

  Journal of Clinical Oncology 20 (14), 3054-3060, 2002-07-15

  American Society of Clinical Oncology (ASCO)

キーワード

• Cancer Research
• Oncology

詳細情報

• CRID: 1360574095395749120
• NII論文ID: 30022788317
• DOI: 10.1200/jco.2002.12.071
• ISSN: 15277755
• ISSN: 0732183X
• ISSN: http://id.crossref.org/issn/0732183X
• Web Site: https://ascopubs.org/doi/pdfdirect/10.1200/JCO.2002.12.071
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