Early alternating chemotherapy and radiotherapy schedule in limited disease stage small cell lung cancer

• Published in: European journal of cancer (1990) Vol. 31; no. 9; pp. 1434 - 1436
• Main Authors: Purohit, A., Charloux, A., Jung, G.-M., Dietemann, A., Fraisse, P., Schumacher, C., Quoix, E.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 1995
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - radiotherapy; Cisplatin - administration & dosage; Combined Modality Therapy; combined treatment modality; Doxorubicin - administration & dosage; Etoposide - administration & dosage; Female; Humans; limited disease; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Male; Middle Aged; Neoplasm Staging; small cell lung cancer; Survival Analysis; Treatment Outcome; limited disease; combined treatment modality; small cell lung cancer
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/0959-8049(95)00209-2

44 patients with limited small cell lung cancer were treated with six cycles of chemotherapy (cisplatinum 60 mg/ m
2 day 1, doxorubicin 40 mg/m
2 day 1, etoposide 100 mg/m
2 days 1–3) alternating with three courses of mediastinal irradiation, the first one starting 7 days after the first day of chemotherapy. A total dose of 55 Gy was delivered. Prophylactic cranial irradiation (30 Gy after the third cycle of chemotherapy) was left to the physician's discretion. 4 patients had radical surgery before combined modality treatment. 29 patients finished the scheduled program. The complete response rate (bronchoscopically confirmed) was 25.6% after two cycles of chemotherapy and 41% at the end of treatment. Median survival time was 17.2 months, with an estimated survival of 32% at 2 years. Main toxicity was haematological with one early toxic death and six premature interruptions of treatment. We conclude that this treatment modality is feasible and efficacious. Prospective studies comparing chemotherapy with alternating or concurrent early radiotherapy schedules in limited disease small cell lung cancer are needed to determine the best treatment modality.