Therapy for small cell lung cancer using carboplatin, ifosfamide, etoposide (without dose reduction), mid-cycle vincristine with thoracic and cranial irradiation.
AffiliationCRC Department of Medical Oncology, Christie Hospital, Manchester, U.K.
MetadataShow full item record
AbstractThe 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.
CitationTherapy 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
JournalEuropean Journal of Cancer
- Intensive therapy for small-cell lung cancer using carboplatin alternating with cisplatin, ifosfamide, etoposide, mid-cycle vincristine, and radiotherapy.
- Authors: Prendiville J, Radford J, Thatcher N, Steward W, Ranson M, Burt P, Stout R
- Issue date: 1991 Aug
- Carboplatin, ifosfamide and etoposide with mid-course vincristine and thoracic radiotherapy for 'limited' stage small cell carcinoma of the bronchus.
- Authors: Thatcher N, Lind M, Stout R, Payne C, Carroll KB, Campbell C, Moussalli H
- Issue date: 1989 Jul
- Intensive combined-modality therapy in small cell lung cancer.
- Authors: Thatcher N, Lorrigan P, Burt P, Stout R
- Issue date: 1994 Jun
- Concurrent cisplatin, prolonged oral etoposide, and vincristine plus chest and brain irradiation for limited small cell lung cancer: a phase II study of the Southwest Oncology Group (SWOG-9229).
- Authors: Thomas CR Jr, Giroux DJ, Stelzer KJ, Craig JB, Laufman LR, Taylor SA, Goodwin JW, Crowley JJ, Livingston RB
- Issue date: 1998 Mar 15
- Single fraction prophylactic cranial irradiation for small cell carcinoma of the lung.
- Authors: Brewster AE, Hopwood P, Stout R, Burt PA, Thatcher N
- Issue date: 1995 Feb