Irinotecan and Cisplatin Combination Chemotherapy Plus Concurrent Thoracic Irradiation for Patients with Limited Disease Small Cell Lung Cancer

Purpose: To evaluate the antitumor activity and safety of irinotecan plus cisplatin combination chemotherapy with concurrent thoracic radiotherapy (TRT) in patients with limited disease (LD) small cell lung cancer (SCLC). Materials and Methods: Patients with pathologically-confirmed LD SCLC with the following inclusion criteria were retrospectively analyzed: age ≥18 years; measurable lesion; Eastern Cooperative Oncology Group Performance Status 0 ∼2; chemotherapy naive; and adequate bone marrow and organ function. Patients received an intravenous (IV) infusion of irinotecan (35 mg/m 2 on days 1, 8, and 15) and cisplatin (60 mg/m 2 on day 1), which was repeated every 4 weeks for up to 6 cycles. Concurrent TRT was administered with the beginning of chemotherapy. Irinotecan was increased to 60 mg/m2 after completion of TRT. Patients with a complete response (CR) subsequently received prophylactic cranial irradiation. Results: Nineteen patients were analyzed. There were 8 patients (42.1%) with CR, 9 patients (47.4%) with partial response, and 1 patient each (5.3%) with stable disease and progressive disease (PD). The overall response rate was 89.5%. The median progression-free survival was 7.6 months (95% confidence interval [CI], 1.3 ∼14.0 months) and the median overall survival was 12.4 months (95% CI, 0.5∼24.2 months). The 2-year survival rate of the CR patients was 75.0%. No grade 4 hematologic toxicity was reported. Frequently reported toxicities were nausea (10 patients), radiation-induced pneumonitis (10 patients), and neutropenia (6 patients). Radiation-related severe toxicities were frequently reported. Three patients had treatment-related deaths. Conclusion: This study supports the activity and tolerability of irinotecan plus cisplatin with concurrent TRT in patients with LD SCLC. (J Lung Cancer 2011;10(1):49 55)