Chemotherapy Alone or Chemotherapy with Chest Radiation Therapy in Limited Stage Small Cell Lung Cancer

Bunn, Paul A.; Lichter, Allen S.; Makuch, Robert W.; Cohen, Martin H.; Veach, Stephen R.; Matthews, Mary J.; Anderson, A.; Edison, Margaret; Glatstein, Eli; Minna, John D.

doi:10.7326/0003-4819-106-5-655

Cited by 209 publications

(45 citation statements)

References 17 publications

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“…The median survival of 15.8 months for all treated patients and 25 months for those who achieved complete remission is comparable to that of other groups of patients with limited small cell cancer so treated (Bunn et al, 1987). Those managed with the induction treatment programme alone, however, had a median survival of 19.2 months and 48% were relapse-free at 2 years, which is superior to that generally reported for such patients.…”

Section: Resultsmentioning

confidence: 45%

“…Even when the disease is initially of limited extent, median survival is approximately [12][13][14][15] months with less than 10% of patients achieving long-term disease-free survival (Bunn et al, 1987;Osterlind et al, 1986). The contribution of maintenance chemotherapy to the outcome in those patients who achieve some degree of disease control following initial treatment is unclear, as is its role in the management of complete responders who may have the potential for long-term survival (Bleechen et al, 1986;Einhorn et al, 1987;Ettinger et al, 1987;Harper et al, 1987;Splinter et al, 1986;Woods and Levi, 1984).…”

mentioning

confidence: 99%

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Maintenance chemotherapy in limited small cell lung cancer: a randomised controlled clinical trial

Byrne

Hazel²,

Trotter³

et al. 1989

Br J Cancer

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Section: Resultsmentioning

confidence: 45%

mentioning

confidence: 99%

Maintenance chemotherapy in limited small cell lung cancer: a randomised controlled clinical trial

Byrne

Hazel²,

Trotter³

et al. 1989

Br J Cancer

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“…The patients' clinical characteristics and course were reviewed and the age, sex, stage ofdisease, history ofchemotherapy treatment, response to chemotherapy, and survival were recorded. The patients were staged as limited, extensive stage disease or extrapulmonary and the response to chemo-therapy was defined as partial or complete as previously described (21). Survival was measured from the initiation ofchemotherapy treatment.…”

Section: Methodsmentioning

confidence: 99%

Restriction fragment length polymorphism studies show consistent loss of chromosome 3p alleles in small cell lung cancer patients' tumors.

Johnson¹,

Sakaguchi²,

Gazdar³

et al. 1988

J. Clin. Invest.

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Previous karyotypic analysis of human small cell lung cancer cell lines has demonstrated a consistent deletion of a portion of the short arm of chromosome 3(pl4-23). DNA prepared from tumors and normal tissues obtained from 24 small cell lung cancer and two extrapulmonary small cell cancer patients was hybridized to four probes that detect restriction fragment length polymorphisms within chromosome region 3p14-21. Of the 25 patients who were heterozygous for at least one marker in this region in the DNA from normal tissue, 23 (92%) showed an unequivocal loss of heterozygosity in the DNA from their tumor tissue. From these studies we conclude that loss of alleles from the short arm of chromosome 3 is a consistent finding in unselected small cell lung cancer patients' tumor DNA.

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“…A treatment policy of late irradiation restricted to responders does not find support in available data (Fox et al, 1980;Bunn et al, 1985) ( Table VII) and treatment of all patients concurrently with the first dose of chemotherapy or 4, 9 or 12 weeks later does not seem to result in major differences. Late addition of the radiotherapy is, however, associated with an often overlooked methodologic enigma.…”

Section: Evaluation Of Responsementioning

confidence: 85%

“…(Bleehen et al, 1983). Updated and more detailed data from a number of these studies are now available (Table VII) (Stevens et al, 1979;Fox et al, 1980;Kies et al, 1982;Bunn et al, 1985;Souhami et al, 1984;Perez et al, 1984;Smyth & Hansen, 1985). Whether chemotherapy with or without thoracic irradiation was employed did not result in significantly different survival durations in the majority of the trials.…”

Section: Evaluation Of Responsementioning

confidence: 99%

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up

1987

Lung Cancer

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Summary One hundred and forty-five patients with limited stage small cell lung cancer were included in a randomized trial to evaluate the effect of chemotherapy with or without chest irradiation. Seventy-six patients were allotted chemotherapy alone while 69 patients received the same chemotherapy plus radiotherapy, 40 Gy in split-course, administered in weeks 6 and 10 after the initiation of chemotherapy. The chemotherapy consisted of lomustine, cyclophosphamide, vincristine and methotrexate. Patients treated with chemotherapy alone survived for a median of 52 weeks compared to 44 weeks in patients receiving the combined regimen (P=0.055). After exclusion of five early deaths and one patient refusing the irradiation plus 14 completely resected patients, the remaining 65 patients receiving chemotherapy alone and the 60 patients treated with chemotherapy plus radiotherapy were included in a new analysis. The difference in survival duration which could be ascribed to treatment with or without chest irradiation thereby diminished (P=0.24). Eighteen months' disease-free survival was obtained in 9.2% of the 65 patients and in 9.8% of the 60 patients. The complete remission rates were 37% and 46%, respectively, (P=0.33) and the median durations of complete remission were 40 weeks and 52 weeks (P=0.67). Treatment failure of the primary tumour occurred in 85% of patients treated with chemotherapy alone in contrast to 61% of patients receiving the combined regimen (P=0.005). Seventy-nine of these patients underwent autopsy at which no residual chest disease was observed in 17% and 37%, respectively (P=0.045). The combined regimen was more toxic than chemotherapy alone resulting in significantly greater dose reductions and more pronounced thrombocytopenia. Lung and pericardial fibrosis was responsible for four deaths among the complete responders in the radiotherapy group.The combined regimen thus tended to be more efficacious with respect to tumour control at the expense, however, of increased toxicity which per se, eliminated a potential improvement of the overall therapeutical results.

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Chemotherapy Alone or Chemotherapy with Chest Radiation Therapy in Limited Stage Small Cell Lung Cancer

Cited by 209 publications

References 17 publications

Maintenance chemotherapy in limited small cell lung cancer: a randomised controlled clinical trial

Maintenance chemotherapy in limited small cell lung cancer: a randomised controlled clinical trial

Restriction fragment length polymorphism studies show consistent loss of chromosome 3p alleles in small cell lung cancer patients' tumors.

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up

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