title: The impact of dose per cycle of etoposide and cisplatin on outcomes in patients with extensive small-cell lung cancer.
abstract: Etoposide/cisplatin is the standard chemotherapy regimen used in the United States for the treatment of small-cell lung cancer (SCLC). A wide variety of dose and schedules have been employed when managing these patients. We conducted an analysis of the phase II/III trials of etoposide/cisplatin in the past 20 years to determine whether the dose and cycle of either drug affected outcomes in patients with extensive SCLC. We identified 15 phase I/II studies, which included 1419 patients. Etoposide doses per cycle ranged from 180 mg/m(2) to 510 mg/m(2) and cisplatin doses per cycle ranged from 80 mg/m2 to 280 mg/m(2). With logistic regression analysis, we found that increasing doses of etoposide resulted in increased complete response rates (P = 0.01) but had no impact on overall response rates. Cisplatin dose per cycle had no influence on complete or overall response. With linear regression analysis, we were unable to find a relationship between survival and dose per cycle of etoposide or cisplatin. Variations in the administration of this regimen had no impact on outcomes in patients with extensive SCLC.
authors.affiliation: Veterans Administration Medical Center, University of Tennessee Cancer Institute, Memphis, USA. hniell@utmem.edu
authors.forename: Harvey B
authors.initials: HB
authors.lastname: Niell
authors.forename: Said
authors.initials: S
authors.lastname: Beganovic
authors.forename: Sylvia
authors.initials: S
authors.lastname: Richey
authors.forename: Jim Y
authors.initials: JY
authors.lastname: Wan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D017322:Clinical Trials, Phase II as Topic; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D002945:Cisplatin