title: Carboplatin and etoposide (CarE) combined with radiotherapy and vincristine, doxorubicin and cyclophosphamide (VAC) in limited small cell lung cancer. A phase II study.
abstract: Sixty-eight patients with limited small cell lung cancer were treated between April 1988 and October 1990 with combination carboplatin 450 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 i.v. on days 1-3 (CarE) for two courses, followed by thoracic radiotherapy (TRT) 50 Gy, and then vincristine 1 mg/m2, doxorubicin 50 mg/m2 and cyclophosphamide 750 mg/m2 on day one (VAC) for four courses. Prophylactic cranial irradiation (30 Gy) was given to patients with CR after completion of chemotherapy. Sixty patients (89%) achieved an objective response (40% complete responses). The median time to progression was 8.5 months and median survival time 12.1 months. Predicted one- and two-year survival was 50% and 12% respectively. Myelosuppression was the main toxicity, with WHO grade 3 and 4 leukopenia occurring in 32% of VAC courses. There were 5 (7%) treatment-related deaths, all of them during VAC. We conclude that the present combination is active in terms of response rate, but it did not demonstrate any superiority in survival. The frequency of haematological toxicity was substantial during VAC courses.
authors.affiliation: Department of Radiotherapy and Oncology, University Hospital of Kuopio, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Virén
authors.forename: K
authors.initials: K
authors.lastname: Liippo
authors.forename: A
authors.initials: A
authors.lastname: Ojala
authors.forename: L
authors.initials: L
authors.lastname: Helle
authors.forename: M
authors.initials: M
authors.lastname: Jakobson
authors.forename: M
authors.initials: M
authors.lastname: Järvinen
authors.forename: S
authors.initials: S
authors.lastname: Paloheimo
authors.forename: E R
authors.initials: ER
authors.lastname: Salomaa
authors.forename: R
authors.initials: R
authors.lastname: Salmi
authors.forename: V
authors.initials: V
authors.lastname: Nikkanen
mesh_terms: D000293:Adolescent; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects; D016190:Carboplatin / Q000008:administration & dosage; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin