Alternating chemotherapy, prophylactic cranial irradiation and late local thoracic irradiation for small-cell lung cancer.
28 consecutive patients with small-cell lung cancer (SCLC) aged 48-78 years (with exclusion of 4 patients over 80 years) were treated with combination chemotherapy in the schedule AAA-BBB-AAA-BBB, where A consisted of cyclophosphamide 1,000 mg/m2, adriamycin 50 mg/m2, and etoposide 100 mg/m2 X 3, and B of cyclophosphamide 1,000 mg/m2, methotrexate 50 mg/m2 and vincristine 1 mg/m2 X 2. Patients in complete remission after 3 courses received prophylactic cranial irradiation, and thoracic irradiation was given after completion of chemotherapy. There were 3 toxic deaths. Of the patients with limited disease, 71% reached complete remission and 24% partial remission; in extensive disease these percentages were 36 and 45%, respectively. Three patients survived more than 2 years, 1 with recurrence of squamous cell carcinoma after 125 weeks. It is concluded that this scheme of combination chemotherapy is as effective as those reported earlier in remission rate and survival in SCLC. However, the addition of thoracic irradiation failed to prevent local relapse in 83% of the patients.
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001921:Brain; D001932:Brain Neoplasms / Q000517:prevention & control / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000532:radiotherapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D013909:Thorax