Etoposide-cisplatin and thoracic radiation therapy salvage of incomplete responders to a noncisplatin induction regimen for limited and extensive small-cell carcinoma of the lung

E. G. Shaw, S. Frytak, R. T. Eagan, R. L. Richardson, E. T. Creagan, J. R. Jett, R. L. Foote, J. Q. Su, D. J. Schaid, R. E. Lee

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Our purpose was to determine the ability of an etoposide-cisplatin (EP)- based regimen to salvage patients with limited and extensive small-cell lung cancer who are incomplete responders to cyclophosphamide-Adriamycin- vincristine-etoposide (CAVE) chemotherapy, and to determine the ability of thoracic radiation therapy (TRT) to salvage CAVE and EP incomplete responders. Fifty-eight patients with small-cell lung cancer (33, limited disease; 25, extensive disease) were entered on this Phase II study between November 1984 and December 1987. Patients received three cycles of CAVE chemotherapy, followed by two cycles of CEPi (cyclophosphamide-etoposide- cisplatin (infusional) and two cycles of CE (cyclophosphamide-etoposide) in conjunction with TRT and prophylactic cranial irradiation (PCI). The overall response rate to CAVE was 62% [5% complete response (CR), 57% partial response (PR) + regression (REGR)]. Of the patients who failed to achieve a CR with CAVE, 81% responded to CEPi (44% CR, 36% PR). Of the patients who did not achieve a CR with either CAVE or CEPi, 89% responded to TRT (65% CR, 24% PR + REGR). For the 33 patients with limited disease, the median survival time and 2-year survival rate were 16.1 months and 24%, respectively. The corresponding figures for the 25 patients with extensive disease were 9.8 months and 4%, respectively. Eleven of these 25 patients were 'downstaged' to 'limited disease' with CAVE + CEPi and then received TRT + PCI + CE. Their median survival time and 2-year survival rate were 12.6 months and 9%, respectively. The EP-based regimen CEPi and TRT were able to convert 44 to 65% of patients to a complete response who had failed to do so with non-EP induction chemotherapy. This study supports the use of an EP regimen with TRT as initial therapy for newly diagnosed small-cell lung cancer.

Original languageEnglish (US)
Pages (from-to)154-158
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume19
Issue number2
DOIs
StatePublished - Apr 1 1996

Keywords

  • Cisplatin
  • Etoposide
  • Small-cell lung cancer
  • Thoracic radiation therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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