title: High-dose combined alkylating agent therapy with autologous stem cell support and chest radiotherapy for limited small-cell lung cancer.
abstract: Although initially responsive to chemotherapy, patients with small-cell lung cancer (SCLC) almost invariably suffer relapse. Recurrent SCLC responds poorly to treatment. Previous trials using high-dose chemotherapy with bone marrow support have commonly used single agents or combined alkylating agents without chest radiotherapy. Among patients with limited disease receiving dose-intensive chemotherapy, locoregional relapse remained the predominant site of first failure. Recent phase II trials using intensive locoregional therapy (aggressive concurrent chemoradiotherapy) have resulted in promising survival. Our trial used combined alkylating agents with autologous marrow support and chest radiotherapy in patients with limited disease in response to conventional-dose induction chemotherapy. Of 19 patients treated, the actuarial survival was 56% with a median follow-up of 18 months following high-dose therapy. Patients who achieved complete or near-complete response prior to high-dose therapy enjoyed the best prognosis. Continued evaluation of intensive systemic and local therapy for SCLC is indicated.
authors.affiliation: Department of Medicine, Dana-Farber Cancer Institute, Boston.
authors.forename: A D
authors.initials: AD
authors.lastname: Elias
authors.forename: L
authors.initials: L
authors.lastname: Ayash
authors.forename: A T
authors.initials: AT
authors.lastname: Skarin
authors.forename: C
authors.initials: C
authors.lastname: Wheeler
authors.forename: G
authors.initials: G
authors.lastname: Schwartz
authors.forename: R
authors.initials: R
authors.lastname: Mazanet
authors.forename: I
authors.initials: I
authors.lastname: Tepler
authors.forename: L
authors.initials: L
authors.lastname: Schnipper
authors.forename: E
authors.initials: E
authors.lastname: Frei
authors.forename: K H
authors.initials: KH
authors.lastname: Antman
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000532:radiotherapy / Q000628:therapy; D003131:Combined Modality Therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000628:therapy
chemical_list: D000477:Alkylating Agents