Limited-stage small cell lung cancer treated with cisplatin/irinotecan and concurrent thoracic radiation therapy.

Abstract

7598 Background: Concurrent chemotherapy and radiation therapy (CRT) is a curative option for limited-stage small cell lung cancer (SCLC). The standard of care in the United States is concurrent etoposide-platinum CRT. In Asia, CRT with irinotecan and cisplatin has been shown to be an effective and tolerable regimen. (Han et al J Clin Oncol 2005 and Jeong et al Lung Cancer 2006) Irinotecan is a potent radiosensitizing agent (Tamura et al Jpn J Cancer Res 1997). Patients with limited-stage SCLC treated with irinotecan-platinum concurrent CRT were identified from our institutional thoracic oncology program database. Methods: 36 patients with limited stage SCLC from 2006-2013 were identified from our database. Ages 49-85. 17 females and 27 males. All patients were treated with cisplatin 30mg/m2 and irinotecan 65mg/m2 on day 1 and 8 every 21 days for a total of 4 cycles, along with concurrent radiation therapy commensurate with cycle 2. 29 patients received BID concurrent radiation therapy (45Gy), and 7 patients received daily dosing (54Gy). 25 patients received prophylactic cranial irradiation. Median follow-up two years; 22 patients followed for over 3 years. Results: Overall radiographic response rate 67% (18 CR, 8 PR). Median overall survival 19 months. 1 year survival 60%: 2 year survival 44%; 3 year survival 30%. No symptomatic pneumonitis with 13% of patients developing symptomatic esophagitis. Conclusions: Irinotecan and cisplatin with concurrent CRT achieved a 30% 3-year overall survival in an American patient population with limited stage SCLC.