Treatment of limited small-cell lung cancer with concurrent etoposide/cisplatin and radiotherapy followed by intensification with high-dose cyclophosphamide: a Southwest Oncology Group study

• Published in: Journal of clinical oncology Vol. 9; no. 3; p. 453
• Main Authors: Goodman, G E, Crowley, J, Livingston, R B, Rivkin, S E, Albain, K, McCulloch, J H
• Format: Journal Article
• Language: English
• Published: United States 01.03.1991
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - mortality; Carcinoma, Small Cell - radiotherapy; Cisplatin - administration & dosage; Combined Modality Therapy; Cyclophosphamide - administration & dosage; Dose-Response Relationship, Drug; Drug Administration Schedule; Etoposide - administration & dosage; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - radiotherapy; Male; Middle Aged; Pilot Projects; Prognosis
• ISSN: 0732-183X
• DOI: 10.1200/JCO.1991.9.3.453

Between March 1986 and May 1988, the Southwest Oncology Group enrolled 58 previously untreated patients with limited small-cell lung cancer on a treatment program that administered high-dose cyclophosphamide (150 mg/kg) as late intensification. Treatment consisted of induction chemo-radiotherapy, (weeks 1 to 11), consolidation chemotherapy (weeks 11 to 18), and intensification (week 18). Median age was 61.5 years. Eighty-nine percent of patients had a Southwest Oncology Group (SWOG) performance status of 0-1. Twenty-one patients completed all prescribed treatments. There were seven treatment-related deaths, four as a result of intensification. Fifty-six patients are available for response analysis. Thirty-two patients achieved a complete remission (CR) (57%) and fifteen achieved a partial remission (PR) (26%). Median survival for all patients is 11.1 months. Among the 21 patients who received intensification, nine remain alive in a CR with a median survival of 27 months. This sequence of treatments was not associated with a survival advantage for the group as a whole, possibly because of the toxicity of induction and consolidation treatment and the delayed administration of high-dose cyclophosphamide.