Oral vinorelbine: a Better Choice for Concurrent Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer

Abstract

Background: Lung cancer is the most common cancer in the world, and causes 1.3 million deaths annually. Approximately 45% of patients diagnosed with non-small cell lung cancer (NSCLC) have locally advanced stage III disease. Standard treatment is concurrent chemoradiotherapy (CCRT) with two drugs, but severe toxicities are common. Several single-agent CCRTs have been developed to overcome this problem.

Methods: We reviewed the records of 24 patients with stage III NSCLC who received single-agent vinorelbine CCRT at the National Cheng Kung University Hospital from January 1, 2005 to May 31, 2009. Nine patients received with vinorelbine intravenous infusion (15 mg/m²/week) and fifteen with oral vinorelbine 40mg/m²/week. Thoracic radiation was given over 6 weeks in 1.8 Gy/day fractions (total median dose of 59.7 Gy). The primary endpoint was the evaluation of time to progression (TTP) of these patients. The secondary endpoints were analysis of therapy-related toxicities and overall response rate.

Results: Median age was 70 years (range: 58-81 years), and median follow-up time was 430 days (range: 101-1363 days). Eighteen patients were male, six were female and the median ECOG grade was 1. Vinorelbine was given for a median of 5.5 weeks (range: 4-8 weeks). All patients completed all planned cycles of CCRT. Seven patients (29.2%) had radiation pneumonitis. No patient had a complete response, and thirteen patients (54.2%) had a partial response. The median time to progression (TTP) was 6.4 months (95% confidence interval: 4-8.7 months), the median survival time was 24 months (95% CI: 13.8-34.9 months), and the 1- and 2-year survival rates were 68.5% and 41.1%, respectively.

Conclusion: Treatment of stage III NSCLC patients with single-agent vinorelbine CCRT had a better median survival time and 2-year survival rates with fewer toxicities when compared with other therapies. Oral vinorelbine with its convenience in administration is an ideal choice for CCRT.