title: Vincristine, doxorubicin and cyclophosphamide with and without etoposide in limited small cell lung cancer.
abstract: A total of 80 patients with limited disease of small cell lung cancer were randomized to receive either vincristine 1 mg/m2 (max. 2 mg), doxorubicin 50 mg/m2 and cyclophosphamide 750 mg/m2 (VAC) i.v. on day 1, or the same drugs and etoposide 80 mg/m2 i.v. daily for 3 days (VACE) every 3 weeks for nine courses. Chest irradiation was given in both regimens after the second course. The response rate was 84% for VAC (41% complete responses) and 75% for VACE (46% complete responses). The median survival time was 10 months with VAC regimen, and 14 months with VACE (difference statistically not significant). The median duration of remission was 8 months with VAC and 14 months with VACE (p = 0.03), and the median survival for complete or partial responders was 12 months and 20 months respectively (p = 0.006). Myelosuppression was significantly greater in the VACE group, and there was one treatment related death in the group receiving VACE. In this study the addition of etoposide to VAC improved the duration of response, but did not lead to longer survival of patients with limited disease of small cell lung cancer.
authors.affiliation: Department of Radiotherapy and Oncology, University Central Hospital, Turku, Finland.
authors.forename: V
authors.initials: V
authors.lastname: Nikkanen
authors.forename: K
authors.initials: K
authors.lastname: Liippo
authors.forename: A
authors.initials: A
authors.lastname: Ojala
authors.forename: M
authors.initials: M
authors.lastname: Jakobsson
authors.forename: M
authors.initials: M
authors.lastname: Järvinen
authors.forename: S
authors.initials: S
authors.lastname: Paloheimo
authors.forename: E
authors.initials: E
authors.lastname: Nordman
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000633:toxicity; D003609:Dactinomycin / Q000008:administration & dosage / Q000633:toxicity; D004317:Doxorubicin / Q000008:administration & dosage / Q000633:toxicity; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage / Q000633:toxicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D014750:Vincristine / Q000008:administration & dosage / Q000633:toxicity
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide