Improved local control of thoracic disease in small cell lung cancer with higher dose thoracic irradiation and cyclic chemotheraphy

• Published in: International journal of radiation oncology, biology, physics Vol. 13; no. 7; pp. 993 - 998
• Main Authors: Papac, R J, Son, Y, Bien, R, Tiedemann, D, Keohane, M, Yesner, R
• Format: Journal Article
• Language: English
• Published: 01.01.1987
• ISSN: 0360-3016

Improvement in survival has developed for patients with small cell lung carcinoma. The authors assess the outcome of treatment with initial cyclic combination chemotherapy including: cyclophosphamide, VP 16-123 and methotrexate combined with radiotherapy (RT), 6000 Gy to the thorax for patients with limited disease and 3000 Gy for patients with extensive disease. The occurrence of encephalopathy in 6 to 19 cases who received cranial irradiation, 3000 Gy, and concomitant chemotherapy was a serious consequence. The most frequent side effects were reversible alopecia and leuconeutropenia. Nausea and vomiting were limited in duration and controlled with antiemetic agents. Thrombopenia of less than 100,000 cu/mm developed in 6 patients. Leuconeutropenia tended to occur with increasing severity in sequential cycles, so that the nadir developed in the 5th and 6th cycles of chemotherapy. Two patients developed radiation pneumonitis with resolution over 2 to 3 months. Six patients had esophagitis during radiotherapy. Severe pulmonary functional impairment was recorded in 7 patients; moderate impairment in 12 patients and mild functional impairment was detected in 23 patients.