To Evaluate the Efficiency and Safety of Nab-paclitaxel Plus Cisplatin and Concomitant Thoracic Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer.

Purpose/Objective(s) To evaluate the efficiency and safety of Nab-paclitaxel plus cisplatin and concomitant thoracic radiotherapy in locally advanced non-small-cell lung cancer. Materials/Methods A total of 68 cases locally advanced NSCLC patients were enrolled in this study, and 38 cases were enrolled so far (1:1 in the experimental group and the control group, 19 cases in each group, 1 case in each group did not complete the treatment, a total of 36 cases were available for statistical analysis). The control group received paclitaxel combined with cisplatin regimen chemotherapy (paclitaxel 175mg/m2 on day 1, cisplatin 75mg/m2 on day 2; every 3-4 weeks for 2 consecutive cycles. Experimental group: nab-paclitaxel weekly at a dose of 40mg/m2, Cisplatin 75mg/m2 and repeated every 3-4 weeks for 2 consecutive cycles. Both groups received concomitant aggressive radical three-dimensional thoracic radiotherapy with continuously accelerated hyperfractionation. The primary endpoint was ORR and safety (including treatment-induced bone marrow suppression, the toxicity of liver and kidney function, cardiotoxicity, radiation pneumonia, and other toxic side effects). Secondary endpoints were local progression-free survival rate, the local recurrence rate of the primary tumor, and the local control rate of the primary tumor. Results 38 patients completed concomitant chemoradiotherapy. The effective rates ORR of experimental group and control group were 89.6% and 68.5%, respectively. The short-term efficacy was CR (0 cases 0%, 1 case 5.2%), PR (17 cases 89.6%, 12 cases 63.3%), SD (1 case 5.2%, 5 cases 26.3%), PD (1 case 5.2%, 1 case 5.2%) P = 0.001. Grade 3/4 leukopenia 2 (10.5%), 14 (73.7%), P = 0.001; grade 3/4 neutropenia 2 (10.5%), 14 (73.7%), P = 0.001; grade 3/4 anemia 1 (5.3%) and 2 (10.5%), P = 0.547; grade 3/4 thrombocytopenia 0(0%) and 2 (10.5%) of, P = 0.146. There were 11 (57.9%) and 6 (31.6%) of grade I radiation esophagitis, and 8 (42.1%) and 13 (68.4%) of grade II esophagitis respectively. No grade III-IV esophagitis was found. Conclusion The ORR and short-term efficiency of nab-paclitaxel plus cisplatin concomitant radiotherapy are better than the control group, and the hematological toxicity is lower than the control group.