Combination chemotherapy and radiation therapy in small cell carcinoma of the lung

Eagan, Robert T.; Maurer, L. Herbert; Forcier, R. Jackson; Tulloh, Marchant

doi:10.1002/1097-0142(197308)32:2<371::aid-cncr2820320213>3.0.co;2-3

Cited by 53 publications

(6 citation statements)

References 34 publications

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“…The median survival of the whole group, eight months, compares favourably with other studies using radiotherapy and chemotherapy alone (Eagan et al, 1973;Hansen et al, 1971). The ability to assess individual response to chemotherapy made differential evaluation of survival results possible and confirms previous suspicions that benefit can be obtained only in patients showing definite response in measurable tumour mass.…”

Section: Discussionsupporting

confidence: 69%

“…We have confirmed that responders to chemotherapy in terms of reduction in tumour size also survive significantly longer than non-responders (Eagan et al, 1973). COMP was used as our chemotherapy combination for the following reasons.…”

Section: Discussionsupporting

confidence: 56%

“…At entry into the trial 33 (58-9%) patients had only intrathoracic disease detected (Eagan et al, 1973) while 23 (41-1 %) had evidence of extrathoracic involvement. Liver metastases shown by a positive liver scan were seen in eight (14-3%) patients, four (7-1%) had positive bone scans, five (8-9%) had positive bone marrow aspiration, one (1-8%) had skin deposits, and six (10-7%) had evidence of inappropriate antidiuretic hormone secretion as shown by hyponatraemia (Na+ <125 mmol/l) in the presence of urinary to plasma osmolality ratio of 3: 1 or greater.…”

Section: Resultsmentioning

confidence: 99%

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Small cell carcinoma: combined approach to treatment.

Gregor¹,

Morgan²,

Morgan³

et al. 1979

Thorax

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Fifty-six patients with untreated small cell carcinoma of the bronchus were treated with three courses of chemotherapy (cyclophosphamide, vincristine, and procarbazine and methotrexate) and assessed for response. Thirty-one patients (55-4%) were classified as responders; they were given a course of radiotherapy and were then randomly allocated to continued cyclical chemotherapy or no further chemotherapy until relapse. Non-responders to chemotherapy were treated with radiotherapy or palliatively. The median survival was 105 months in responders and 6 months in non-responders (P<001). The one-year survival in responders was 42%. There was no statistical difference in survival between patients treated with continued chemotherapy and those treated at relapse. Sixty-nine per cent of patients experienced no side effects from chemotherapy.Three indicators of non-response to chemotherapy were identified -exercise tolerance at diagnosis, macroscopic liver metastases, and inappropriate ADH secretion.Small cell carcinoma of the bronchus is a disseminated disease in most patients at presentation (Selawry, 1974). After reports of response and improved survival using radiotherapy (Miller et al, 1969), and chemotherapy we have tested whether a combination of chemotherapy and radiotherapy could be used to prolong useful life and whether prognostic factors could be identified. Methods

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Section: Discussionsupporting

confidence: 69%

Section: Discussionsupporting

confidence: 56%

Section: Resultsmentioning

confidence: 99%

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Small cell carcinoma: combined approach to treatment.

Gregor¹,

Morgan²,

Morgan³

et al. 1979

Thorax

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“…Small cell anaplastic carcinoma continues to be the subtype where the greatest advances are being achieved and the most active combinations have obtained response rates of 70-859, with complete remissions in 30"; of patients.ls73 16', 162 165 Cyclophosphamide and vincristine have been consistent components of these combinations with other drugs including methotrexate, adriamycin, procarbazine, CCNU being added in different s t u d i e~. '~~~ 160,[162][163][164][165][166] The median duration of response with these combinations was generally in the region of seven months with median survivals of 9-12 months. These relatively short term responses although clearly superior to single agent therapy indicate that drug resistance tends to develop early in this cell type precluding long term control with these combinations alone.…”

Section: Chemotherapymentioning

confidence: 99%

A Status Report on the Management of Solid Tumours

Levi

1978

Australian and New Zealand Journal of Medicine

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Progressive improvements in the management of certain paediatric and haematological malignancies have provided guidelines for the current approaches to the management of the more common solid tumours of adults. These include precise histopathological grading; comprehensive evaluation of extent of disease; staging classifications accurately correlated with prognosis and progressive evaluation of available therapeutic modalities for all stages of disease in an attempt to define the best combination of local and systemic forms of therapy. Breast cancer is reviewed in detail as an example of the more responsive tumours where screening programs; improvements in pathological and clinical staging and the introduction of systemic chemotherapy together with optimal use of other methods of treatment for the various stages of disease gives hope for a significant improvement in long term survival statistics. Lung cancer has also been reviewed as an example of the more resistant types of cancer where screening programmes and current therapy including the use of combination chemotherapy have given minor encouragement but not had a definite influence on long term survival. Some further gains may still be achieved with currently available techniques but major improvements will probably require the development of better therapeutic tools including radiotherapy with high linear energy transfer particles; new chemotherapeutic agents and specific forms of immunotherapy. It is also quite possible that completely different forms of therapy for these resistant tumours will be necessary to reach the desired goal of long term improvements in survival.

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“…A large number of cooperative groups are studying a variety of treatment sched ules using as many as 10 to 12 agents in different sequences. 23 Immunostimu lation and chemotherapy are advocated by Israel @24 The measurement of relapse free survival in patients with early cancer may serve as a better index of chemotherapy's effectiveness. Elective CNS and/or liver irradiation is being studied for the eradication of microme tastases.…”

Section: Lung Cancermentioning

confidence: 99%