title: Randomized trial comparing induction chemotherapy versus induction chemotherapy followed by maintenance chemotherapy in small-cell lung cancer. European Lung Cancer Working Party.
abstract: OBJECTIVE
  The European Lung Cancer Working Party (ELCWP) performed a randomized trial with the primary end point to determine if maintenance chemotherapy with 12 courses of etoposide (120 mg/m2 on days 1 and 3) and vindesine (3 mg/m2 on day 3) could improve progression-free survival in small-cell lung cancer (SCLC) patients who responded to six courses of induction chemotherapy with ifosfamide, etoposide, and an anthracycline (doxorubicin or epirubicin).
  
  
  RESULTS
  Among 235 eligible patients initially registered, 91 were randomized to receive maintenance therapy, including seven patients who were no longer responding. Among 84 randomized responders, progression-free survival was significantly improved (P = .003) by maintenance therapy, with median durations (maintenance v follow-up) of 25 versus 12 weeks after the second randomization, but survival was not significantly increased (P = .10), with median durations of 48 and 38 weeks. However, in a multi-variate analysis that took into account disease extent, maintenance therapy, Karnofsky performance status (PS), and absolute dose-intensity (ADI) of anthracycline given during induction, limited disease (LD) and maintenance were found to be independent positive predictors of survival.
  
  
  CONCLUSIONS
  We conclude that maintenance chemotherapy in responding patients is beneficial in SCLC.
authors.affiliation: Department of Medicine, Institut Jules Bordet, Bruxelles, Belgium.
authors.forename: J P
authors.initials: JP
authors.lastname: Sculier
authors.forename: M
authors.initials: M
authors.lastname: Paesmans
authors.forename: G
authors.initials: G
authors.lastname: Bureau
authors.forename: V
authors.initials: V
authors.lastname: Giner
authors.forename: J
authors.initials: J
authors.lastname: Lecomte
authors.forename: J
authors.initials: J
authors.lastname: Michel
authors.forename: M C
authors.initials: MC
authors.lastname: Berchier
authors.forename: O
authors.initials: O
authors.lastname: Van Cutsem
authors.forename: U
authors.initials: U
authors.lastname: Küstner
authors.forename: F
authors.initials: F
authors.lastname: Kroll
authors.forename: R
authors.initials: R
authors.lastname: Sergysels
authors.forename: P
authors.initials: P
authors.lastname: Mommen
authors.forename: J
authors.initials: J
authors.lastname: Klastersky
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005060:Europe; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012074:Remission Induction; D015996:Survival Rate; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D015251:Epirubicin; D005047:Etoposide; D004317:Doxorubicin; D014751:Vindesine; D007069:Ifosfamide