PubMed Health⌕ Search

Biomedical subjects

Richard H Wheeler

Publications and source records attributed to Richard H Wheeler.

4 recordsLinked to original sources
PubMed2005

The long-term results of a pilot study of three times a day radiotherapy and escalating doses of daily cisplatin for locally advanced non-small-cell lung cancer.

PURPOSE: This analysis was performed to determine the long-term results of a Phase I trial that included 3-times-a-day radiotherapy (TIDRT) and concurrent daily cisplatin (CDDP) for Stage III non-small-cell lung cancer. METHODS AND MATERIALS: Twenty patients with Stage III non-small-cell lung cancer were treated with TIDRT delivered over 12 weekdays that included 57.6 Gy administered in 1.5 Gy fractions at 8 a.m. and 4 p.m., and 1.8 Gy fractions at noon. AP-PA fields were used at 8 a.m. and 4 p.m. Opposed oblique off cord fields were used at noon. The first 5 patients were given no CDDP, the second 5 patients received 5 mg/m2 of CDDP, and the remaining 10 patients received 7.5 mg/m2 of CDDP. All survivors were followed for greater than 5 years. RESULTS: The maximum tolerated dose of daily CDDP during this program of radiation therapy was 7.5 mg/m2. None of the patients died as a result of toxicity. The median survival was 19.2 months, and the 5-year survival rate was 25%. Tumor response and patterns of failure were also evaluated. CONCLUSIONS: This study was performed to determine the maximum tolerated dose of CDDP when administered daily during an aggressive program of TIDRT. The survival results were promising, suggesting that the combination of TIDRT and systemic therapy deserves further study.

Antineoplastic Agents↗
PubMed2002

Phase I study of hyperfractionated accelerated radiotherapy and escalating doses of daily cisplatin for patients with locally advanced non-small-cell lung cancer.

PURPOSE: To determine the maximal tolerated dose of daily cisplatin (CDDP) administered during an aggressive program of hyperfractionated accelerated radiotherapy (t.i.d. RT) for locally advanced non-small-cell lung cancer (NSCLC). METHODS AND MATERIALS: Twenty patients with Stage III NSCLC were treated with RT administered three times daily and escalating doses of concurrent daily CDDP. The t.i.d. RT was delivered on 12 weekdays as follows: a total of 57.6 Gy was administered using 10-MV X-rays in 1.5-Gy fractions at 8 am and 4 pm and 1.8-Gy fractions at 12 pm. AP-PA fields were used in the morning and afternoon, and oblique fields, which included no spinal cord, were used at 12 pm. The first group of 5 patients was not given CDDP, the second group of 5 patients received 5 mg/m(2) of CDDP, and the last group of 10 patients received 7.5 mg/m(2). Toxicity was evaluated using the National Cancer Institute Common Toxicity Criteria. RESULTS: The first group of 5 patients received no CDDP. One of these patients developed both Grade 3 esophagitis and Grade 3 pneumonitis. The second group of 5 patients received 5 mg/m(2) of CDDP. One of these patients developed Grade 3 esophagitis. The last group of 10 patients received 7.5 mg/m(2) of CDDP. Four of these patients developed Grade 3 toxicity and one developed Grade 4 toxicity. None of the patients died as a result of toxicity. The median survival for the 20 patients was 19 months. The tumor response and patterns of failure were also evaluated. CONCLUSION: This study was performed to determine the maximal tolerated dose of CDDP when administered daily during an aggressive program of t.i.d. RT. A dose of 7.5 mg/m(2) daily was determined to be the maximal tolerated dose, because this dose caused Grade 3 or 4 toxicity in 50% of the patients who received it.

Antineoplastic Agents↗
PubMed2002

Concurrent chemoradiation therapy with cisplatin and paclitaxel for locally advanced non-small cell lung cancer: long-term follow-up of a phase I trial.

The purpose of this trial was to evaluate the feasibility of concurrent paclitaxel/cisplatin and conventional thoracic irradiation in locally advanced non-small cell lung cancer (NSCLC). Ambulatory patients with medically inoperable or unresectable stage II-III NSCLC, and performance status 0-2 were eligible. Patients were not excluded from this trial if they had lost more than 5% of their body weight during the preceding 3 months, and/or if they had small ipsilateral pleural effusion. The initial dose of paclitaxel/cisplatin was 110 and 50 mg/m(2), and was escalated through five dose levels. Four cycles of chemotherapy were planned; the first two cycles were given concurrently with radiotherapy (4 weeks apart), followed by two additional cycles (every 3 weeks). Conventional chest radiotherapy to a total dose of 60 Gy (2 Gy per day) was delivered in 6 weeks. Forty-three patients were enrolled of which 38 were evaluable for response. Dose-limiting toxicities were grade 4 neutropenia (43% of patients) and grade 3 esophagitis (26% of patients) during the chemoradiotherapy phase. Grade > or = 2 acute and late pulmonary toxicity occurred in 10 and 68% of the patients, respectively. In most patients, prompt symptomatic and radiologic improvement was observed with early steroid administration. The volume of lung receiving 15-30 Gy was correlated with late pulmonary toxicity. The overall response was 84% with ten complete and 22 partial responses. The median survival was 16.5 months (95% confidence interval, 9.5 to 25) for those patients evaluable for response. After a median follow-up of 70 months, 5 (13%) patients are alive without evidence of disease. The maximum tolerated dose (MTD) of paclitaxel and cisplatin with concurrent radiotherapy is at dose level 3 paclitaxel (135 mg/m(2)) and cisplatin (75 mg/m(2)). Toxicity, although significant, was manageable in the great majority of the patients. The activity observed with this regimen is particularly noteworthy when considering the advanced nature of these patients, and the fact that patients (N=18) with poor risk factors were included in the study.

Adolescent↗