Combined chemotherapy and radiotherapy versus best supportive care in the treatment of inoperable non-small-cell lung cancer.
Between October 1984 and July 1988, 119 patients with limited-stage inoperable non-small-cell lung cancer (NSCLC) were randomized to receive either active treatment (arm 1) or best supportive treatment (arm 2). Arm 1 patients received 3 courses of chemotherapy with cisplatin (100 mg/m2, day 1) and etoposide (125 mg/m2 i.v., day 1; 250 mg/m2 p.o., day 2-3), followed by radiotherapy (4,000 cGy/20 fractions/4 weeks). Arm 2 patients only received best supportive care. Fifty-three and 66 patients were randomized to arms 1 and 2, respectively. Thirty-eight patients in arm 1 and 57 in arm 2 were evaluable for survival. Median survivals of arms 1 and 2 were 12.4 and 8.7 months, respectively (p = 0.047). In the multivariate analysis, only age and histology were independent prognostic variables in predicting survival. The overall response rate after chemotherapy was 20.6% (complete remission 5.9%, partial remission 14.7%). Toxicities were mainly anemia, leukopenia, vomiting and alopecia. This study suggests that active treatment has marginal survival benefit in NSCLC though with considerable toxicities.
Leung
W T
WT
Department of Clinical Oncology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin.
Shiu
W C
WC
Pang
J C
JC
Lau
J
J
Tao
M
M
Leung
S F
SF
Teo
P
P
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis
D005047:Etoposide; D002945:Cisplatin