Intercalated radio-chemotherapy in small cell lung cancer: toxicity and implications for future regimens

• Published in: Radiotherapy and oncology Vol. 20; no. 3; pp. 177 - 180
• Main Authors: Hoskin, P.J., Parton, D., Yarnold, J.R., Cherryman, G., Smith, I.E.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.1991
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - radiotherapy; Combined Modality Therapy; Etoposide - administration & dosage; Female; Humans; Ifosfamide - administration & dosage; Intercalated radio-chemotherapy; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Male; Middle Aged; Pulmonary Fibrosis - etiology; Radiation Injuries - etiology; Radiotherapy Dosage; Small cell lung cancer; Toxicity; Toxicity; Small cell lung cancer; Intercalated radio-chemotherapy
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/0167-8140(91)90094-W

Thirty-six patients with small cell lung cancer have been treated using chemotherapy comprising carboplatin, ifosphamide and etoposide. A total of six cycles of chemotherapy were given. In 15 patients with limited disease intercalated radio-chemotherapy was used in which two 5-day courses of hyperfractionated radiotherapy were given to the thorax after the first and second cycles of chemotherapy. Each course of thoracic radiotherapy delivered 15 Gy in 15 fractions over 5 days. Oesophagitis occurred in 7 patients (40%), in 5 of whom this was severe (WHO grade 3). Radiological pneumonitis developed in 6 patients (40%) with subsequent fibrosis in 2 patients. These effects are greater than would be expected with this dose of radiation alone and reflect marked enhancement of normal tissue toxicity.