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Increased survival with high‐dose multifield radiotherapy and intensive chemotherapy in limited small cell carcinoma of the lung
Author(s) -
Shank Brenda,
Scher Howard,
Hilaris Basil S.,
Pinsky Carl,
Martin Michelle,
Wittes Robert E.
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19851215)56:12<2771::aid-cncr2820561209>3.0.co;2-a
Subject(s) - medicine , oncology , small cell lung carcinoma , chemotherapy , radiation therapy , small cell carcinoma , carcinoma , lung cancer
From June 1979 through April 1982, we treated 35 patients with limited small cell carcinoma on an intensive chemo‐radio‐immunotherapy regimen, consisting of induction with cyclophosphamide, doxorubicin, and vincristine, alternately cycled with VP‐16 and cisplatin. Patients were stratified by performance status and randomized to thymosin, fraction V, or no thymosin. Induction was followed by consolidation, consisting of prophylactic whole‐brain radiotherapy and multifield radiotherapy to the primary and mediastinum with cyclophosphamide and vincristine. Patients who were complete responders (CRs) postconsolidation resumed maintenance immediately. Patients were followed from 1 to 3.8 years (median, 2.2 years) at the time of analysis. After induction, 35% (12/34) had become CRs; after consolidation radiotherapy, an additional 10/34 became CRs for a total CR rate of 65% (22/34). There were only 9/34 local failures (26%), of which all but one were inpatients who had not become CRs. A prolonged median survival (21 months) has been obtained in patients with limited small cell carcinoma of lung treated with an intensive combined modality regimen. At 1 year, survival is 83%; at 2 years, 46%. There is a 33% long‐term survival (>3 years). There is no difference in survival or recurrence rate between patients treated with or without thymosin.