title: A phase III comparison of etoposide/cisplatin with or without added ifosfamide in small-cell lung cancer.
abstract: A total of 92 patients with small-cell lung cancer (SCLC) were randomized to receive cisplatin (80 mg/m2, day 1)/etoposide (100 mg/m2, days 1, 3, 5) (PE) or cisplatin (80 mg/m2, day 1)/etoposide (100 mg/m2, days 1, 3, 5)/ifosfamide (2 g/m2, days 1, 2, 3) (PEI) combination chemotherapy. After 2 courses of chemotherapy, patients with limited disease (LD) received chest irradiation of 40-50 Gy. Of the 89 patients who could be wholly evaluated, the overall response rate was 78% for PE and 74% for PEI therapy (NS). For all patients the complete response (CR) rates were 14 versus 21%, respectively, and 22 versus 30% for LD. However, the median survival times for all patients were 55 weeks for PE therapy versus 56 weeks for PEI therapy (NS). The 2-year survival rates were 15 and 17%, respectively, for all patients (NS). There was no difference in the duration of response between PE and PEI therapy in cases with CR or partial response. However, severe leukopenia (< 2,000/mm3) occurred more often after PEI (73%) than after PE (44%) therapy (p < 0.05). These results suggest that PEI is not superior to PE chemotherapy in SCLC. The use of ifosfamide in multimodality treatment regimens needs to be studied further.
authors.affiliation: First Department of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyamoto
authors.forename: T
authors.initials: T
authors.lastname: Nakabayashi
authors.forename: H
authors.initials: H
authors.lastname: Isobe
authors.forename: H
authors.initials: H
authors.lastname: Akita
authors.forename: Y
authors.initials: Y
authors.lastname: Kawakami
authors.forename: T
authors.initials: T
authors.lastname: Arimoto
authors.forename: M
authors.initials: M
authors.lastname: Asakawa
authors.forename: A
authors.initials: A
authors.lastname: Suzuki
authors.forename: T
authors.initials: T
authors.lastname: Fujikane
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D015996:Survival Rate
chemical_list: D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide