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Carboplatin, etoposide, and accelerated hyperfractionated radiotherapy for elderly patients with limited small cell lung carcinoma
Author(s) -
Jeremic Branislav,
Shibamoto Yuta,
Acimovic Ljubisa,
Milisavljevic Slobodan
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980301)82:5<836::aid-cncr6>3.0.co;2-h
Subject(s) - medicine , carboplatin , etoposide , oncology , radiation therapy , carcinoma , small cell lung carcinoma , chemotherapy , small cell carcinoma , cisplatin
BACKGROUND It is not clear how well elderly patients with limited small cell lung carcinoma tolerate intensive chemotherapy, and they have often been treated with palliative intent. As an alternative strategy, the authors designed and employed a short term combination regimen consisting of carboplatin and etoposide with accelerated hyperfractionated radiotherapy. METHODS Seventy‐five patients ages ≥70 years with a Karnofsky performance status of ≥60 and no other major medical problems, were enrolled in this study and 72 were evaluable. The protocol consisted of intravenous carboplatin (400 mg/m 2 ) given on Days 1 and 29, oral etoposide (50 mg/m 2 ) given on Days 1‐21 and 29‐49, and accelerated hyperfractionated radiation at a dose of 1.5 gray (Gy) administered twice daily (total dose, 45 Gy) starting on Day 1. RESULTS The median follow‐up period was 61 months. The response rate was 75%, and complete response was observed in 57% of the patients. The median survival time was 15 months, and the 2‐ and 5‐year survival rates were 32% and 13%, respectively. Acute Grade 3 leukopenia, thrombocytopenia, and esophagitis were observed in 8.3%, 11%, and 2.8% of the patients, respectively. Only one patient experienced Grade 4 acute toxicity (thrombocytopenia). No late toxicity of Grade 3 or higher was observed. CONCLUSIONS This combined treatment program was tolerable and produced promising long term results. Elderly patients should not universally be treated with palliative intent. Further studies exploring a potentially more effective regimen are warranted. Cancer 1998;82:836‐41. © 1998 American Cancer Society.