Radiotherapy alone or with chemotherapy in the treatment of small-cell carcinoma of the lung. Medical Research Council Lung Cancer Working Party.
This report gives the complete findings at one year of a study comparing radiotherapy (Rt) with radiotherapy followed by 3-drug chemotherapy (RtC3) in the treatment of histologically proven small-cell carcinoma of the lung of limited extent. Over the 12-month period there was a significantly increased survival for the RtC3 patients (P = 0.002) and at 12 months 18% of the 121 Rt but 34% of the 115 RtC3 patients were alive (P = 0.009). The median survival for the Rt series was 25 weeks and for the RtC3 series 43 weeks. There was evidence of recurrence of the primary cancer in 32 (32%) of the 99 Rt and 20 (26%) of the 76 RtC3 patients who died. Distant metastases appeared earlier and were more frequent in the Rt series (P less than 0.0001) and over the 12-month period 79% of the Rt and 57% of the RtC3 patients developed distant metastases (P less than 0.0005). At 12 months only 8% of the Rt but 26% of the RtC3 patients were alive and free of metastases. Adverse reactions occurred much more frequently in the RtC3 series; 32% of the Rt series as against 83% of the RtC3 series had reactions, the most common being nausea and vomiting (13% Rt, 71% RtC3) and the most serious being marrow depression (23% Rt, 54% RtC3). No important differences were found among the survivors in the 2 series at 3, 6 or 12 months, in general condition, physical activity or respiratory function. It is concluded that radiotherapy plus chemotherapy was superior to radiotherapy alone, although chemotherapy did not protect patients from recurrence of primary growth.
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011788:Quality of Life; D011882:Radiotherapy, High-Energy
D000970:Antineoplastic Agents