title: Intercalated radio-chemotherapy in small cell lung cancer: toxicity and implications for future regimens.
abstract: Thirty-six patients with small cell lung cancer have been treated using chemotherapy comprising carboplatin, ifosphamide and etoposide. A total of six cycles of chemotherapy were given. In 15 patients with limited disease intercalated radio-chemotherapy was used in which two 5-day courses of hyperfractionated radiotherapy were given to the thorax after the first and second cycles of chemotherapy. Each course of thoracic radiotherapy delivered 15 Gy in 15 fractions over 5 days. Oesophagitis occurred in 7 patients (40%), in 5 of whom this was severe (WHO grade 3). Radiological pneumonitis developed in 6 patients (40%) with subsequent fibrosis in 2 patients. These effects are greater than would be expected with this dose of radiation alone and reflect marked enhancement of normal tissue toxicity.
authors.affiliation: Department of Radiotherapy and Oncology, Royal Marsden Hospital, Sutton, Surrey, U.K.
authors.forename: P J
authors.initials: PJ
authors.lastname: Hoskin
authors.forename: D
authors.initials: D
authors.lastname: Parton
authors.forename: J R
authors.initials: JR
authors.lastname: Yarnold
authors.forename: G
authors.initials: G
authors.lastname: Cherryman
authors.forename: I E
authors.initials: IE
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology*; D011879:Radiotherapy Dosage
chemical_list: D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide