CANCERS BRONCHIQUES NON A PETITES CELLULES NON METASTATIQUES NON RESECABLES |
|
|
référence |
traitement |
stade |
n |
% RO |
survie médiane |
survie à 3 ans |
p |
|
CHIMIOTHERAPIE VERSUS RADIOTHERAPIE |
|||||||
|
Kaasa, 1988 (1) |
I. CDDP (70 mg/m2)-VP16 |
tous |
116 |
21 |
10,4 mo |
2 |
|
|
II. RT (42 Gy) |
118 |
42 |
10,2 mo |
3 |
|||
|
Johnson, 1990 (2) |
I. VDS |
Non résécable |
106 |
10 |
10,1 mo |
7 |
|
|
II. RT (60 Gy) |
106 |
30 |
8,6 mo |
5 |
|||
|
III. RT + VDS |
107 |
34 |
9,4 mo |
7 |
|||
|
Kubota, 1994
(3) |
RO
ou NC à 2 cures CDDP-VDS |
III |
|
|
|
|
|
|
I.
- |
32 |
50 |
447 j |
3 |
|||
|
II. RT (50-60 Gy) |
31 |
52 |
461 j |
29 |
|||
|
Sculier, 1999 (4) |
RO à 3 cures de MMC-Ifo-CDDP |
III |
|
|
|
(2 ans) |
NS |
|
I.
3 cures même chimio |
60 |
|
42 s |
18 |
|||
|
II. RT (60 Gy) |
55 |
|
54 s |
22 |
|||
|
CHIMIOTHERAPIE D’INDUCTION
AVANT RADIOCHIMIOTHERAPIE
|
|||||||
|
Vokes, 2007 (5) |
I. radiochimiothérapie
concomitante immédiate : 66 Gy + carbo(AUC2)- paclitaxel(50) /sem |
III non résécable |
161 |
67 |
|
19 % |
0,3 |
|
II . chimiothérapie
d’induction : 2x carbo(AUC6)-paclitaxel(200) puis radiochimiothérapie
(cf supra) |
170 |
61 |
|
23 % |
|||
|
Berghmans, 2009 (6) |
CDDP (60) +VNR+emcitabine |
III non résécable |
|
|
|
|
0,19 |
|
I avec RT conc à l’induction |
26 |
57% |
|
|
|||
|
II. avec RT conc en consolidation |
29 |
79% |
23,9m |
|
|||
|
CHIMIOTHERAPIE DE CONSOLIDATION APRES RADIOCHIMIOTHERAPIE |
|||||||
|
Hanna, 2008 (7) I |
RT (59,4 Gy) + cisplatine-étoposide
concomitant puis |
203 |
|
|
|
30,2 % |
|
|
1. Docétaxel (75 mg/m² x 3) |
73 |
|
|
|
27,1 % |
NS |
|
|
2. Suivi |
74 |
|
|
26,1 % |
|||
|
RADIOCHIMIOTHERAPIE APRES CHIMIOTHERAPIE D’INDUCTION |
|||||||
|
Nyman, 2009 (8) A |
2 x paclitaxel 200 + Carbo AUC 6 puis |
152 |
28 % |
|
|
31 % |
NS |
|
|
49 |
50 % |
|
33 % |
|||
|
II. paclitaxel 12 mg/m²/j + RT 60
Gy (6sem) |
50 |
33 % |
|
36 % |
|||
|
III. paclitaxel 60 mg/m²/sem + RT
60 Gy (6sem) |
52 |
45 % |
|
21 % |
|||
Références
(1) Kaasa S, Thorud E, Host H, Lien HH, Lund E, Sjolie I. A randomized study evaluating radiotherapy versus chemotherapy in patients with inoperable non-small cell lung cancer. Radiother Oncol 1988 Jan;11(1):7-13.
(2) Johnson DH, Einhorn LH, Bartolucci A, Birch R, Omura G, Perez CA, et al. Thoracic radiotherapy does not prolong survival in patients with locally advanced, unresectable non-small cell lung cancer. Ann Intern Med 1990 Jul 1;113(1):33-8.
(3) Kubota K, Furuse K, Kawahara M, Kodama N, Yamamoto M, Ogawara M, et al. Role of radiotherapy in combined modality treatment of locally advanced non-small-cell lung cancer. J Clin Oncol 1994 Aug;12(8):1547-52.
(4) Sculier JP, Paesmans M, Lafitte JJ, Baumohl J, Thiriaux J, van Cutsem O, et al. A randomised phase III trial comparing consolidation treatment with further chemotherapy to chest irradiation in patients with initially unresectable locoregional non-small-cell lung cancer responding to induction chemotherapy. European Lung Cancer Working Party. Ann Oncol 1999 Mar;10(3):295-303.
(5) Vokes EE, Herndon JE, Kelley MJ, Cicchetti MG, Ramnath N, Neill H, et al. Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage III Non-small-cell lung cancer: Cancer and Leukemia Group B. J Clin Oncol 2007 May 1;25(13):1698-704.
(6) Hanna N, Neubauer M, Yiannoutsos C, McGarry R, Arseneau J, Ansari R, et al. Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S. Oncology. J Clin Oncol 2008 Dec 10;26(35):5755-60.
(8) (7) Jalal SI, Riggs HD, Melnyk A, Richards D, Agarwala A, Neubauer M, et al. Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a phase III trial from the Hoosier Oncology Group (HOG) and US Oncology. Ann Oncol 2012 Jul;23(7):1730-8.
(8) Nyman J, Friesland S, Hallqvist A, Seke M, Bergstrom S, Thaning L, et al. How to improve loco-regional control in stages IIIa-b NSCLC? Results of a three-armed randomized trial from the Swedish Lung Cancer Study Group. Lung Cancer 2009 Jul;65(1):62-7.