title: [Combined alternating radiochemotherapy in stage III (TNM) (limited disease) small cell bronchial carcinoma: a phase II study with carboplatin/etoposide/vincristine and alternating radiotherapy].
abstract: BACKGROUND
  The combination of radio-chemotherapy is accepted standard in limited-disease small cell lung cancer, but the best way of combining the two modalities is still unknown. To test an alternating regime of early radiotherapy with hypofractionated radiotherapy we performed a phase II study in stage III small cell lung cancer.
  
  
  METHODS
  32 SCLC patients (n = 7 IIIa, n = 25 IIIb) were treated with a weekly alternating regime with either chemotherapy or radiotherapy. Chemotherapy included carboplatin (AUC5), etoposide (3 x 120 mg/m2) and vincristine (2 mg), repeated on day 28 for six cycles. Radiotherapy started one week before chemotherapy and was applied weekly 1 x 4 Gy, using a split-course regimen.
  
  
  RESULTS
  Combined radio-chemotherapy was well tolerated with dose-limiting hemotoxicity and very few cases of oesophagitis. Overall response was 75%, median survival 14.5 months and the 2-year survival was 34.4%. 5 patients are still living now for more than 29 months. Treatment failure was local and systemic in 34% of the patients. Systemic failure included 6 patients with brain metastases.
  
  
  CONCLUSIONS
  Combined radio-therapy in small-cell lung cancer using an alternating hypofractionated regimen is well tolerated. Response rate and 2-year survival are promising. Local and systemic failure is an ongoing problem and requires better local and systemic control of the disease.
authors.affiliation: Lungenklinik Heckeshorn, Pneumologie II, Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Serke
authors.forename: U
authors.initials: U
authors.lastname: Riedel
authors.forename: N
authors.initials: N
authors.lastname: Schönfeld
authors.forename: J
authors.initials: J
authors.lastname: Pannhorst
authors.forename: B
authors.initials: B
authors.lastname: Förster
authors.forename: R
authors.initials: R
authors.lastname: Loddenkemper
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002283:Carcinoma, Bronchogenic / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000009:adverse effects; D019583:Dose Fractionation, Radiation; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin
vernacular_title: Kombinierte alternierende Chemo-Strahlentherapie beim kleinzelligen Bronchialkarzinom im Stadium III (TNM) (limited disease): Eine Phase-II-Studie mit Carboplatin/Etoposid/Vincristin und alternierender Strahlentherapie.