[Comparison between high-dose chemotherapy assisted with autologous peripheral blood stem cell and conventional chemotherapy in the treatment of small cell lung cancer].
BACKGROUND
To compare the response and survival time of autologous peripheral blood stem cell assisted high-dose chemotherapy with conventional chemotherapy in treatment of small cell lung cancer (SCLC) and to access treatment-related toxicities of high-dose chemotherapy.


METHODS
Twenty-seven patients with SCLC at age <= 65 yrs entered this study. Thirteen patients were given at high dose of cyclophosphamide (CTX,3. 0 g/ m(2) ) , etoposide (VP16 ,750 mg/ m(2) ) , carboplatin (CBP ,400 mg/ m(2) ) and cisplatin (DDP ,60 mg/ m(2) ) with autologous peripheral blood stem cell support by G-CSF (300mug/ d for 5 or 6 days) after one to three cycles of conventional chemotherapy with ifosfamide + vindesine + DDP ( IVP regimen) or ifosfamide + VP16 + DDP ( IEP regimen) or CTX+ VP16 + DDP (CEP regimen) . Forteen patients were given two courses of conventional chemotherapy with IVP or CEP or VP16 + DDP(EP regimen) . Patients in stage II and stage IIIA were given irradiation or surgical recection after chemotherapy and others by chemotherapy continuously.


RESULTS
Response rate to conventional chemotherapy was 78. 6 % after one cycle and 85. 7 % after two cycles respectively , and that to high-dose chemotherapy was 100 %. The difference was not statistically significant ( P > 0. 05) . The survival time was 58 to 569 days for high-dose chemotherapy and 90 to 430 days for conventional chemotherapy respectively , and Log Rank test showed P < 0. 001. The main toxicity of high-dose chemotherapy was bone marrow suppression and all patients occured grade IV leukopenia and 61. 5 % occured grade IV thrombocytopenia , but they recovered in half month after stem cell transplantation and nobody died from high-dose chemotherapy.


CONCLUSIONS
High-dose chemotherapy with support of autologous peripheral blood stem cell is an effective therapy for SCLC. Patients has higher response and longer survival time and less toxicity.
Department of Pulmonary Diseases , Shanghai Chest Hospital , Shanghai 200030 , P. R. China.
H
H
Jian
Y
Y
Zhao
X
X
Zhang
M
M
Liao