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Continuation of chemotherapy versus supportive care alone in patients with inoperable non‐small cell lung cancer and stable disease after two or three cycles of MACC. Results of a randomized prospective study
Author(s) -
Buccheri Gian Franco,
Ferrigno Domenico,
Curcio Antonio,
Vola Ferruccio,
Rosso Alberto
Publication year - 1989
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(19890201)63:3<428::aid-cncr2820630305>3.0.co;2-v
Subject(s) - medicine , lomustine , chemotherapy , discontinuation , lung cancer , regimen , cyclophosphamide , chemotherapy regimen , performance status , toxicity , prospective cohort study , randomized controlled trial , surgery , oncology , quality of life (healthcare) , vincristine , nursing
Abstract Recommendations concerning the continuation of chemotherapy in nonresponding patients with non‐small cell lung cancer (NSCLC) and stable disease after the first chemotherapy test are empirical and often conflicting. Between 1984 and 1987, 116 inoperable NSCLC patients were treated with methothrexate, doxorubicin, cyclophosphamide, and lomustine (MACC regimen). After two or three cycles of therapy, 74 patients were judged to have stable disease and assigned at random either to chemotherapy maintenance with the same regimen (38 subjects) or to chemotherapy discontinuation (36 subjects). The two study groups were comparable for all the major prognostic factors. Median time to progression was 26 weeks for the chemotherapy group compared to 24 weeks for the nonchemotherapy group ( P = NS). Median survival was prolonged in the treatment arm (47 weeks) compared to the nontreatment arm (30 weeks), which was statistically nonsignificant. A patient self‐assessment of the quality of life revealed a significantly worse tolerance to therapy and a better physical condition in the chemotherapy group. Objective MACC toxicity was significant with two treatment‐related deaths. This study failed to demonstrate sufficient therapeutic benefits to justify the increased cost and toxicity of continuing treatment in nonresponding NSCLC patients.