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    Therapy for small cell lung cancer using carboplatin, ifosfamide, etoposide (without dose reduction), mid-cycle vincristine with thoracic and cranial irradiation.

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    Authors
    Prendiville, Joseph A
    Lorigan, Paul C
    Hicks, F
    Leahy, B
    Stout, Ronald
    Burt, Paul A
    Thatcher, Nick
    Affiliation
    CRC Department of Medical Oncology, Christie Hospital, Manchester, U.K.
    Issue Date
    1994
    
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    Abstract
    The aim of this study was to assess the efficacy and toxicity of intensive chemotherapy, administered without dose reduction, with cranial and thoracic radiotherapy given when possible as a single fraction in small cell lung cancer. 87 patients were eligible on the basis of good performance status, normal or near normal biochemistry and clinical staging, 73 limited and 14 extensive stage, computed tomography scanning was not mandatory. Six cycles of carboplatin, ifosfamide and etoposide with vincristine on day 15 at 4 weekly intervals were planned. Dosages were not reduced in response to myelosuppression. Prophylactic cranial irradiation (PCI) as a single fraction after the first cycle and thoracic irradiation (when possible as a single fraction) following the third cycle were delivered. Seventy-two per cent of patients completed the protocol. Complete response rate was 55% and 26% of patients had a partial response. The median nadirs of neutropenia were 0.5 x 10(9)/l and thrombocytopenia 14 x 10(9)/l, with 6% probable treatment-related deaths. Performance status and dyspnoea improved markedly to normal or near normal levels following the second course. Brain metastases occurred in 13% of patients. The median survival was 16.2 months with a 2-year survival of 31% (95% confidence interval, 24-41%) for a minimum follow-up of 26 months. These results compare favourably with other combined modality studies, using multiple radiotherapy fractions with cisplatin-based combinations and dosage reduction for patients staged in more anatomical detail. The toxicity spectrum and efficacy data could lead to the use of this chemotherapy regimen with haematopoietic growth factors and, in the future, peripheral blood progenitor cell rescue.
    Citation
    Therapy for small cell lung cancer using carboplatin, ifosfamide, etoposide (without dose reduction), mid-cycle vincristine with thoracic and cranial irradiation. 1994, 30A (14):2085-90 Eur. J. Cancer
    Journal
    European Journal of Cancer
    URI
    http://hdl.handle.net/10541/97241
    DOI
    10.1016/0959-8049(94)00363-A
    PubMed ID
    7857708
    Type
    Article
    Language
    en
    ISSN
    0959-8049
    ae974a485f413a2113503eed53cd6c53
    10.1016/0959-8049(94)00363-A
    Scopus Count
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