1083 A completed phase I/II trial of neoadjuvant chemotherapy (CT) with cisplatin and vinorelbine followed by accelerated thoracic irradiation, (TRT) in inoperable NSCLC

Goal To improve local control by accelerating the delivery of TRT. Design Inoperable and measurable stages II, Ill-A and B NSCLC, KS ≥ 70. Prior weight loss allowed. Treatment cisplatin 100 mg/m 2 week 1 and 5, vinorelbine 30 mg/m 2 weekly × 5 (15 mg/m 2 on week 2 followed by TRT, 30 fractions of 2 Gy in four weeks, once daily weeks 1 and 2, BID weeks 3 and 4 (same biological dose as 30 daily fractions of 2 Gy). Results From 11–92 to 11–94, 42 eligible patients entered and 39 are evaluable. Response rate 46.2% (18/39) after CT and 71.8% (28/39) after TRT. 24 patients have progressed (1st relapse: 6 in RT field, 16 outside RT field [7 in brain], 2 unknown), and 20 have died. Actuarial median survival 12.0 months. ≥ grade III toxicities post TRT in 23.1% (9/39:7 oesophagus [1 grade 5], 1 lung, 1 skin). Median weight loss during treatment was 2.5 kg. Conclusions Cisplatin and vinorelbine is an active induction CT regimen. Accelerated TRT to 60 Gy is well tolerated and may yield better local control than standard TRT.