title: Alternating radiotherapy and chemotherapy schedules in small cell lung cancer, limited disease.
abstract: Sixty-three evaluable patients with limited small cell lung carcinoma were entered into two pilot studies alternating 6 cycles of combination chemotherapy (Doxorubicin 40 mg/m2 d 1; VP16213 75 mg/m2 d 1, 2, 3; Cyclophosphamide 300 mg/m2 d 3, 4, 5, 6; and Methotrexate 400 mg/m2 d 2--plus folinic acid rescue--or Cis-Platinum 100 mg/m2 d 2) with 3 courses of mediastinal radiotherapy as induction treatment. The first course of radiotherapy started 10 days after the second cycle of chemotherapy; there was a 7 day rest between chemotherapy and radiotherapy courses. This 6 month induction treatment was followed by a maintenance chemotherapy. The total mediastinal radiation dose was increased from 4500 rad in the first study to 5500 rad in the second. Both protocols obtained a complete response (CR) rate of greater than 85% (with fiberoptic bronchoscopy and histological verification). Local control at 2 years was 61% in the first study and 82% in the second. Relapse-free survival at 2 years was 32 and 37%, respectively. Toxicity was acceptable. We conclude that our results justify further clinical research in alternating radiotherapy and chemotherapy schedules.
authors.forename: R
authors.initials: R
authors.lastname: Arriagada
authors.forename: T
authors.initials: T
authors.lastname: Le Chevalier
authors.forename: P
authors.initials: P
authors.lastname: Baldeyrou
authors.forename: J L
authors.initials: JL
authors.lastname: Pico
authors.forename: P
authors.initials: P
authors.lastname: Ruffie
authors.forename: M
authors.initials: M
authors.lastname: Martin
authors.forename: H M
authors.initials: HM
authors.lastname: el Bakry
authors.forename: P
authors.initials: P
authors.lastname: Duroux
authors.forename: J
authors.initials: J
authors.lastname: Bignon
authors.forename: B
authors.initials: B
authors.lastname: Lenfant
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D011379:Prognosis; D011882:Radiotherapy, High-Energy / Q000009:adverse effects