Small cell lung cancer ; Combination chemotherapy ; Concurrent radiotherapy
Abstract
In order to assess the efficacy of alternating schedule chemotherapy on the outcome of patients with small cell lung cancer and effect of concurrent thoracic radiotherapy in limited disease, fifty five eligible patients with SCLC were treated with chemotherapy consisting of cyclophosphamide, adriamycin and vincristine(CAV) alternating with etoposide and cisplatin(EP). Thoracic radiotherapy was administered to the patients with limited stage disease Overall response rate was 64% with 20% of complete response. The response rate was 78%(CR 39%,PR 39%)in the patients with limited stage disease, and 53%(CR 6%, PR 47%)in those with extensive stage disease. With median follow-up period of 14 months (341+), the median survivals in patients of limited stage and extended disease were 15 months and 10 month, respectively (p<0.02) and median survivals in patients with CR, PR, and SD+PD were 20, 11.3, 8.5months, respectively(p<0.01) In patients with limited stage patients with or without concurrent use of thoracic radiotherapy, the response rates were 82%(CR 42%, PR 41%) and 67%(CR 33%, PR 34%) and median survivals were 15.8 months and 11.8 months, respectively.There were no life threatening side effects. This results suggest that alternating chemotherapy with CAV and EP may be useful as a treatement strategy in small cell lung cancer and concurrent use of thoracic radiotherapy in limited stage patients improve survival, but it was not significant statistically.