Frontiers in Oncology (Oct 2022)

Evaluation of the efficacy and feasibility of concurrent weekly docetaxel-nedaplatin and hypo-fractionated radiotherapy in atypical histologic subtypes of primary and metastatic mediastinal malignancies

  • FanJun Meng,
  • XinLei Ai,
  • XinLei Ai,
  • XinLei Ai,
  • Bin Wang,
  • Bin Wang,
  • Bin Wang,
  • Yin Zhou,
  • Su Li,
  • Su Li,
  • Su Li,
  • DaQuan Wang,
  • DaQuan Wang,
  • DaQuan Wang,
  • FangJie Liu,
  • FangJie Liu,
  • FangJie Liu,
  • NaiBin Chen,
  • NaiBin Chen,
  • NaiBin Chen,
  • Rui Zhou,
  • Rui Zhou,
  • Rui Zhou,
  • JinYu Guo,
  • JinYu Guo,
  • JinYu Guo,
  • XiaoYan Huang,
  • XiaoYan Huang,
  • XiaoYan Huang,
  • ShaoHan Yin,
  • ShaoHan Yin,
  • ShaoHan Yin,
  • Bo Qiu,
  • Bo Qiu,
  • Bo Qiu,
  • Hui Liu,
  • Hui Liu,
  • Hui Liu

DOI
https://doi.org/10.3389/fonc.2022.974394
Journal volume & issue
Vol. 12

Abstract

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BackgroundWe aimed to evaluate the efficacy and feasibility of concurrent weekly docetaxel-nedaplatin and hypo-fractionated radiotherapy (hypo-RT) in atypical histologic subtypes of primary and metastatic mediastinal malignancies.MethodsFifty-four patients diagnosed with atypical primary or metastatic mediastinal malignancies were retrospectively reviewed. 30 patients received concurrent weekly docetaxel and nedaplatin and hypo-RT (CChRT group) and 24 patients had hypo-RT alone (hRT group). Overall response rate (ORR), in-field locoregional progression-free survival (LPFS) and toxicities were analyzed. The radiobiological effect was evaluated by the LQRGC/TCP model, incorporating four “R”s of radiobiology, Gompertzian tumor growth and radio-sensitizing effect of chemotherapeutic agent. The biologically effective doses (BEDs) were calculated.ResultsThe median follow-up time was 29.2 months for all patients. The ORR was 86.7% in CChRT group, compared with 62.5% in hRT group (p=0.033). The 2-year in-field LPFS of CChRT and hRT group was 73.4% and 47.3%, respectively (p=0.003). There was no significant difference of any >=Grade 3 toxicities between the two groups (p=0.754). The mean total dose and mean BED by the LQRGC/TCP model in CChRT group were 58.2Gy and 72.34Gy, versus 52.6Gy and 67.25Gy in hRT group.ConclusionsConcurrent weekly docetaxel-nedaplatin and hypo-RT achieved promising in-field LPFS and tolerable toxicities compared with hypo-RT alone in different histologic subtypes of primary and metastatic mediastinal malignancies.

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