Long-term survival and toxicity in small cell lung cancer: Southwest oncology group study

• Published in: The American journal of medicine Vol. 77; no. 3; pp. 415 - 417
• Main Authors: Livingston, Robert B., Stephens, Ronald L., Bonnet, John D., Grozea, Petre N., Lehane, Daniel E.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1984; Elsevier
• Subjects: Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Small Cell - mortality; Carcinoma, Small Cell - physiopathology; Carcinoma, Small Cell - therapy; Chemotherapy; Combined Modality Therapy; Humans; Lung Neoplasms - mortality; Lung Neoplasms - physiopathology; Lung Neoplasms - therapy; Medical sciences; Neoplasm Staging; Pharmacology. Drug treatments; Prognosis; Radiotherapy - adverse effects; Antineoplastic agent; Human; Chemotherapy; Polychemotherapy; Respiratory disease; Toxicity; Tumor; Oat cell carcinoma; Radiotherapy; Survival; Bronchopulmonary
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/0002-9343(84)90095-0

In the first study of combined chemotherapy and radiation therapy for small cell lung cancer by the Southwest Oncology Group, 17 patients survived more than five years after treatment was initiated (4.6 percent). Late relapse, or a second primary malignancy three to six years after diagnosis, accounted for death in five of these patients. Late recurrences involved the chest, bone, and liver; none occurred in the central nervous system. Disease-free survival continues in 10 patients (6 percent of those with limited disease and 1 percent of those with extensive-stage disease) at a minimal follow-up in excess of six years. One definite case of chronic treatment-related toxicity occurred: congestive cardiomyopathy after 450 mg/m 2 of doxorubicin, successfully managed with digitalis and diuretics. One severe neurologic problem (orthostatic hypotension with preterminal dementia) and two less severe neurologic complications (occasional falling episodes without documented cause and cerebrovascular accident) may be treatment-related. Progressive pulmonary disability, post-herpetic pain syndromes, organic brain syndrome, and hematologic abnormalities have not been observed to date. Nitrosourea administration and/or co-administration of a nitrosourea or methotrexate during the induction phase of treatment with radiotherapy to the brain may account for the higher incidence of complications observed by others in long-term survivors.