Short communication Dose-intensified accelerated vindesine–ifosfamide–cisplatin (VIP) chemotherapy followed by high-dose accelerated hyperfractionated radiotherapy in patients with pathologically proven stage IIIB non-small cell lung cancer: a feasibility study Dirk De Ruysscher a, * , Yolande Lievens b , Paul Van den Brande c , Kris Nackaerts d , Johan Vansteenkiste d a Department of Radiation and Medical Oncology, Sint-Maarten Ziekenhuis, Rooienberg 25, 2570 Duffel, Belgium b Department of Radiotherapy, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium c Department of Pulmonology, Sint-Maarten Ziekenhuis, Rooienberg 25, 2570 Duffel, Belgium d Department of Pulmonology (Respiratory Oncology Unit), University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium Received 4 February 2002; received in revised form 14 April 2002; accepted 10 June 2002 Abstract This study shows the feasibility of accelerated vindesine–ifosfamide–cisplatin chemotherapy, immediately followed by intensive radio- therapy to the residual tumour in responding patients, in 16 patients with pathologically proven stage IIIB non-small lung cancer. All toxicities were reversible, with only two of ten patients experiencing grade 3 oesophagitis, no treatment-related deaths and no serious late effects. q 2002 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Locally advanced non-small cell lung cancer; Stage IIIB; Combined modality treatment; Accelerated radiotherapy; Dose intensification 1. Introduction Locally advanced inoperable non-small cell lung cancer (NSCLC) is generally treated with combined chemotherapy and radiotherapy, but the overwhelming majority of the patients still die due to local and/or distant cancer [2,9,11,15]. The proof of the principle that repopulation of tumour clonogens during treatment is an important reason for treatment failure came from the CHART (Continuous Hyperfractionated Accelerated Radiation Therapy) trial [14]. However, different studies suggest that a radiation dose above 54 Gy, as used in CHART, is needed to obtain local control in the majority of patients, that repopulation of clonogenic tumour cells only starts after a lag period of about 4 weeks after the start of radiotherapy, and that repo- pulation of tumour cells probably also takes place during chemotherapy [1,3,4]. Although the concomitant delivery of chemotherapy and radiotherapy obviously represents short- ening of the overall treatment time of both modalities with possible gain of survival, its greater toxicity makes dose intensification of any modality and incorporation of novel agents more difficult to achieve [3,5,6]. We therefore explored the feasibility of a novel concept of delivering high-dose accelerated chemotherapy followed by high-dose accelerated radiotherapy in 16 patients with pathologically proven stage IIIB disease, in order to achieve high total doses of each treatment modality, and both given in a short overall treatment time. 2. Patients and methods 2.1. Inclusion criteria Patients with pathologically proven stage IIIB NSCLC were eligible if they had an ECOG performance status of 0 or 1 and less than 10% weight loss over the last 3 months. Mixed pathologies with a small cell or bronchiolo-alveolar component were excluded. Distant metastases were ruled out by standard staging consisting of a computed tomogra- phy (CT) scan of the thorax and upper abdomen including the liver and both adrenals, a brain CT scan, and a bone scan completed with a bone CT scan in case of equivocal find- Radiotherapy and Oncology 64 (2002) 33–36 0167-8140/02/$ - see front matter q 2002 Elsevier Science Ireland Ltd. All rights reserved. PII: S0167-8140(02)00144-5 www.elsevier.com/locate/radonline * Corresponding author. Present address: Department of Radiotherapy, Academic Hospital Maastricht, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands.