Outpatient Intensive Chemotherapy for Small Cell Lung Cancer: Five Years Experience of Modified ‘ICE’ Ifosfamide Carboplatin and Etoposide

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) Vol. 14; no. 5; pp. 367 - 371
• Main Authors: Hand, S., Baker, J., Smith, A.P., Macbeth, F.R.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.10.2002; Elsevier
• Subjects: Administration, Oral; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carboplatin - administration & dosage; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - pathology; Chemotherapy; Etoposide - administration & dosage; Female; Humans; Ifosfamide - administration & dosage; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Male; Medical sciences; Mesna - administration & dosage; Middle Aged; Outpatients; Pharmacology. Drug treatments; Prognosis; Small cell lung cancer, ‘ICE’ chemotherapy, modified regimen; Survival; Small cell lung cancer, ‘ICE’ chemotherapy, modified regimen; Antineoplastic agent; modified regimen; Mesna; Prognosis; Intravenous administration; Intensification; Bronchopulmonary; Isomerases; Bronchus disease; Ambulatory; Antimitotic; Small cell carcinoma; Platinum II Complexes; Human; Lung disease; DNA topoisomerase (ATP-hydrolysing); Drug combination; Respiratory disease; Enzyme; Ifosfamide; Oral administration; Etoposide; Enzyme inhibitor; Malignant tumor; 'ICE' chemotherapy; Podophyllotoxine derivatives; Alkylating agent; Chemotherapy; Oxazaphosphinane derivatives; Small cell lung cancer; Treatment; Nitrogen mustard; Carboplatin; Therapeutic protocol
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1053/clon.2002.0097

Introduction Small Cell Lung Cancer (SCLC) is increasingly being treated in the district general hospital setting. The search for an active regimen which can be given with the least toxicity and best outcomes led us to use a modified ICE (Ifosfamide, Carboplatin and Etoposide) regimen and modify it further by using oral mesna instead of intravenous mesna. Method All patients selected to receive the modified ICE regime over a 5-year period were included in our study. All patients were assessed for performance status and prognostic factors. Only those with WHO performance status 0–1 and Manchester prognostic score 0–3 were considered for ICE chemotherapy. All patients were followed up for 1 year after recruitment was completed. Results Median survival for all 32 patients was 18.4 months (CI 12.2–24.6) and for the 28 patients with limited disease the median survival was 19.9 months (CI 8.2–31.6). Toxicity levels were low with no neutropenic deaths. One patient died three days after treatment was started due to disease progression. A total of 6 patients remained alive one year after recruitment was completed. Five out of the 6 were followed up for at least 2 years. Conclusion Using this out-patient modified ICE regime we have achieved a median survival comparable to other active chemotherapy regimes for SCLC with no significant increase in toxicity.Copyright 2002 The Royal College of Radiologists. Published by Elsevier Science Ltd. All rights reserved .