Cisplatin and etoposide (EP) is a common chemotherapy protocol for concurrent chemo-irradiation for patient with stage III NSCLC. In 2004 based on phase II studies our center adopted a protocol of weekly low dose Cisplatin (20mg/m2) and Docetaxel ( 20mg/m2 )(PD) with concurrent radiotherapy (RT) 60-66Gy. This is a retrospective comparison of the two regimens treated between Jan 2004 till Sept 2015.
Patient demographics, tumour characteristics along with toxicity using (CTCAE 4.0) was collected. Progression free survival (PFS) and overall survival (OS) was calculated from treatment commencement until August 2017.
81 patients were treated between 2004-2015 with PD/RT; 19 patients were treated between 2008-2015 with EP/RT, patient and tumour characteristics were comparable except for a slight preponderance of males and smokers in the PD/RT group and stage IIIA in EP/RT group.
The PD/RT group experienced significantly lower grade 3/4 heamatological toxicities than the EP/RT group; 4.9% vs 36.9% neutropenia;1.2% vs 10.5% thrombocytopenia and 6.2% vs 10.5% anemia; moderate renal impairment was lower in the PD/RT group 12.3% vs 18.8%. Nausea was higher in EP with grade 3 nausea 10.5%; oesphagitis was similar in both groups however the pneumonitis rate was higher in the EP/RT group at 21.1% Vs 2.5%.
Median PFS was 11.5 months in EP/RT vs 10 months in the PD/RT groups; the OS was 22months in the EP/RT vs 21months PD/RT group which was not significant. 36.8% (7) were alive with no progression in the EP/RT and 27.2 % (22) alive with no progression PD/RT.
Both the regimens gave acceptable results with a similar PFS and OS which compared well with published studies. The better toxicity profile of the PD/RT regimen warrants a randomised controlled trial. The long study period and the retrospective nature limits firmer recommendations.