Effect of amifostine on toxicities associated with sequential chemotherapy and radiation therapy for unresectable non-small-cell lung cancer

Results of a phase II trial

Scott P. Tannehill, Minesh P. Mehta, Marilyn Larson, Barry Storer, John Pellet, Timothy J. Kinsella, Joan H. Schiller

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Purpose: To determine the effect of amifostine on the safety and efficacy of induction chemotherapy with high-dose cisplatin and vinblastine followed by large-field thoracic irradiation to 60 Gy in patients with stage IIIA or IIIB non-small-cell lung cancer (NSCLC). Patients and Methods: Twenty-six patients with unresectable stage IIIA or IIIB NSCLC were entered onto the study between May 1991 and November 1994. Patients received amifostine (740 or 910 mg/m2) followed by cisplatin (120 mg/m2) on days 1 and 29. Vinblastine (5 mg/ m2) was given weekly for 5 weeks with no amifostine pretreatment. Following chemotherapy, patients received amifostine (340 mg/m2 4 days a week for 5 weeks, or 200 mg/m2 5 days a week for 6 weeks) 15 minutes before definitive thoracic radiation therapy to a total dose of 60 Gy in 6 weeks. Results: Twenty-five patients were assessable far response and survival. The objective response rate was 60%. One-, 2-, and 3- year survival rates were 55%, 23%, and 23%. There was no grade 3 or greater renal toxicity during chemotherapy or grade 3 or greater esophagitis during radiation therapy. Neutropenia (secondary to vinblastine use) was the only grade 4 toxicity. There were no treatment-related deaths. Conclusion: Amifostine can be administered safely wit high-dose cisplatin, vinblastine, and radiation therapy for NSCLC. The response rate and survival data provide no evidence that amifostine impairs response to treatment. Amifostine appears to reduce cisplatin-related nephrotoxicity and radiation-induced esophagitis.

Original languageEnglish (US)
Pages (from-to)2850-2857
Number of pages8
JournalJournal of Clinical Oncology
Volume15
Issue number8
StatePublished - Aug 1997

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Amifostine
Non-Small Cell Lung Carcinoma
Radiotherapy
Vinblastine
Drug Therapy
Cisplatin
Esophagitis
Thorax
Survival Rate
Wit and Humor
Induction Chemotherapy
Neutropenia
Radiation
Kidney
Safety
Survival
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Tannehill, S. P., Mehta, M. P., Larson, M., Storer, B., Pellet, J., Kinsella, T. J., & Schiller, J. H. (1997). Effect of amifostine on toxicities associated with sequential chemotherapy and radiation therapy for unresectable non-small-cell lung cancer: Results of a phase II trial. Journal of Clinical Oncology, 15(8), 2850-2857.

Effect of amifostine on toxicities associated with sequential chemotherapy and radiation therapy for unresectable non-small-cell lung cancer : Results of a phase II trial. / Tannehill, Scott P.; Mehta, Minesh P.; Larson, Marilyn; Storer, Barry; Pellet, John; Kinsella, Timothy J.; Schiller, Joan H.

In: Journal of Clinical Oncology, Vol. 15, No. 8, 08.1997, p. 2850-2857.

Research output: Contribution to journalArticle

Tannehill, Scott P. ; Mehta, Minesh P. ; Larson, Marilyn ; Storer, Barry ; Pellet, John ; Kinsella, Timothy J. ; Schiller, Joan H. / Effect of amifostine on toxicities associated with sequential chemotherapy and radiation therapy for unresectable non-small-cell lung cancer : Results of a phase II trial. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 8. pp. 2850-2857.
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abstract = "Purpose: To determine the effect of amifostine on the safety and efficacy of induction chemotherapy with high-dose cisplatin and vinblastine followed by large-field thoracic irradiation to 60 Gy in patients with stage IIIA or IIIB non-small-cell lung cancer (NSCLC). Patients and Methods: Twenty-six patients with unresectable stage IIIA or IIIB NSCLC were entered onto the study between May 1991 and November 1994. Patients received amifostine (740 or 910 mg/m2) followed by cisplatin (120 mg/m2) on days 1 and 29. Vinblastine (5 mg/ m2) was given weekly for 5 weeks with no amifostine pretreatment. Following chemotherapy, patients received amifostine (340 mg/m2 4 days a week for 5 weeks, or 200 mg/m2 5 days a week for 6 weeks) 15 minutes before definitive thoracic radiation therapy to a total dose of 60 Gy in 6 weeks. Results: Twenty-five patients were assessable far response and survival. The objective response rate was 60{\%}. One-, 2-, and 3- year survival rates were 55{\%}, 23{\%}, and 23{\%}. There was no grade 3 or greater renal toxicity during chemotherapy or grade 3 or greater esophagitis during radiation therapy. Neutropenia (secondary to vinblastine use) was the only grade 4 toxicity. There were no treatment-related deaths. Conclusion: Amifostine can be administered safely wit high-dose cisplatin, vinblastine, and radiation therapy for NSCLC. The response rate and survival data provide no evidence that amifostine impairs response to treatment. Amifostine appears to reduce cisplatin-related nephrotoxicity and radiation-induced esophagitis.",
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