Combination chemotherapy of cisplatin, 5-fluorouracil, and vindesine plus concurrent hyperfractionated thoracic radiotherapy for treatment of locally advanced non-small cell lung cancer

Between June 1993 and May 1994, Ten patients with locally advanced unresectable non-small cell lung cancer (NSCLC) were treated with a combination chemotherapy plus concurrent hyperfractionated thoracic radiotherapy. The chemotherapy consisted of 5-fluorouracil (500mg/m given on day 1-5), cisplatin (20mg/m given on day 1-5), and vindesine (3mg/m given on day 1, 8), and was repeated with a four-week interval through 3 cycles. The thoracic radiotherapy (1.25 Gy/fraction) was given twice daily for 5 consecutive days per week for 5-6 weeks, reaching a total dose of 62.5-70 Gy. An objective respose rate was 80% and a median survival time was 17.3 months. Although non-hematologicic toxicities were generally mild and tolerable, hématologie toxicities were severe and inevitable with severe neutopenia (WHO grade 3 or 4) being observed in all patients. We stopped this trial because of its severe hématologie toxicity after ten patients were evaluated. However, this combined modality treatment was highly effective for locally advanced NSCLC. Some change in the chemotherapy regimen, such as dose attenuation to reduce the hématologie toxicity, will be necessary to accomplish this treatment modality as a multi-institutional study.