• Shinji Atagi, Masaaki Kawahara, Tomohide Tamura, Kazumasa Noda, Koshiro Watanabe, Akira Yokoyama, Takahiko Sugiura, Hiroshi Senba, Satoshi Ishikura, Hiroshi Ikeda, Naoki Ishizuka, Nagahiro Saijo, and Japan Clinical Oncology Group (JCOG9812).
• National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka 591-8555, Japan. s-atagi@kch.hosp.go.jp
• Jpn. J. Clin. Oncol. 2005 Apr 1; 35 (4): 195-201.

BackgroundThe purpose of this study was to evaluate whether radiotherapy with carboplatin would result in longer survival than radiotherapy alone in elderly patients with unresectable stage III non-small cell lung cancer (NSCLC).MethodsEligible patients were 71 years of age or older with unresectable stage III NSCLC. Patients were randomly assigned to the radiotherapy alone (RT) arm, irradiation with 60 Gy; or the chemoradiotherapy (CRT) arm, the same radiotherapy and additional concurrent use of carboplatin 30 mg/m(2) per fraction up to the first 20 fractions.ResultsThis study was terminated early when 46 patients were registered from November 1999 to February 2001. Four patients (one in the RT arm, three in the CRT arm) were considered to have died due to treatment-related causes. The JCOG Radiotherapy Committee assessed these treatment-related deaths (TRDs) and the compliance with radiotherapy in this trial. They found that 60% of the cases corresponded to protocol deviation and 7% were protocol violation in dose constraint to the normal lung, two of whom died due to radiation pneumonitis. As to the effectiveness for the 46 patients enrolled, the median survival time was 428 days [95% confidence interval (CI) = 212-680 days] in the RT arm versus 554 days (95% CI = 331 to not estimable) in the CRT arm.ConclusionsDue to the early termination of this study, the effectiveness of concurrent use of carboplatin remains unclear. We re-planned and started a study with an active quality control program which was developed by the JCOG Radiotherapy Committee.

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