title: Ifosfamide, etoposide, and thoracic irradiation therapy in 163 patients with unresectable small cell lung cancer.
abstract: One hundred sixty-three patients with small cell lung cancer were treated with six courses, at 3-week intervals, of ifosfamide (5 g/m2) with mesna and etoposide. Thoracic radiotherapy was delivered to the limited stage (LS) patients. The complete response rate (CR, determined clinically and radiologically) was 76% for the 78 LS patients with a further 14% partial response (PR). The majority of the CRs were confirmed on a follow-up bronchoscopy. The CR rate was 27% for extensive stage (ES) patients with another 38% undergoing a partial response. The median survival for LS patients was 11 months, (16 months for CR confirmed by rebronchoscopy) and 8 months for ES patients. The 2-year actuarial survival for LS patients is 27%, follow-up ranges from 12 months to 30 months with a median of 22 months. Toxicity was not severe for the patient population, of whom only 20% had a good performance status before chemotherapy. Parental antibiotics were required on 4% of all 844 chemotherapy courses and 12% of courses were delayed due to side effects. The majority of responses occurred within the first two courses of chemotherapy and there was a corresponding improvement in the patients' symptoms and performance status. The regimen produced rapid tumor response with corresponding improvement in symptoms without marked toxicity and allowed further treatment development.
authors.affiliation: CRC Department of Medical Oncology, Christie Hospital & Holt Radium Institute, Manchester, United Kingdom.
authors.forename: N
authors.initials: N
authors.lastname: Thatcher
authors.forename: T
authors.initials: T
authors.lastname: Cerny
authors.forename: R
authors.initials: R
authors.lastname: Stout
authors.forename: H
authors.initials: H
authors.lastname: Anderson
authors.forename: P V
authors.initials: PV
authors.lastname: Barber
authors.forename: R J
authors.initials: RJ
authors.lastname: Wolstenholme
authors.forename: P
authors.initials: P
authors.lastname: Barnes
authors.forename: A
authors.initials: A
authors.lastname: Deiraniya
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008140:Lorazepam / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D015080:Mesna / Q000008:administration & dosage; D008787:Metoclopramide / Q000008:administration & dosage; D008875:Middle Aged
chemical_list: D005047:Etoposide; D008787:Metoclopramide; D015080:Mesna; D008140:Lorazepam; D007069:Ifosfamide