Etoposide-Cisplatin Alternating with Vinorelbine-Cisplatin Versus Etoposide-Cisplatin Alone in Patients with Extensive Disease Combined with Small Cell Lung Cancer

Abstract

Background: The aim of this study was to evaluate the efficacy of alternating etoposide-cisplatin and vinorelbine-cisplatin (EP-NP) compared with an etoposide-cisplatin (EP) regimen for advanced combined small cell carcinomas. Materials and Methods: Histologically confirmed combined small cell carcinoma patients who met the inclusion criteria were randomly assigned (1:1) into either the EP-NP setting (group A) or the EP setting (group B). The primary endpoint was progression-free survival in patients who received at least one dose of treatment. Results: Eighty-two patients entered into this trial, 42 in group A and 40 in group B. The objective response rates in group A and group B were 42.9% and 32.5%, respectively (p=0.334). Survival analysis showed that median progression-free survival was 6.1 months in group A, which was significantly longer than the 4.1 months in group B (p=0.041). However, as to overall survival, no significant difference was found between the two groups (11.0 vs 10.1 months in groups A and B, respectively, p=0.545). No unexpected side effects were observed in either group. Conclusions: The EP-NP regimen for combined small cell carcinomas prolonged progressionfree survival compared with the EP regimen. Further clinical investigations are warranted.

Importance of Performing Radiotherapy and Chemotherapy in the Same Clinic and Bad Prognostic Factors for Small-cell Lung Cancer Patients

“…In this study, acceptable toxicity values were found when the results were compared with those from other studies (10,13).…”

“…These results suggest that RT is effective for the patients who do not shown a good response to CT despite the different reported results in the literature (5,31). The response rates to CT for SCLC were 60-95% in many studies (6,4,10,5). However, the total response rate to CT was 45% in our study because these patients were sent from other clinics after disease progression or bad results of CT.…”

“…This treatment results in a complete response rate of 80% or higher, a median survival in excess of 17 months, and a 5-year cancer-free survival rate of 12-25% in best series (6,4,10,5).…”

High pretreatment neutrophil–lymphocyte ratio predicts recurrence and poor prognosis for combined small cell lung cancer

“…Combined small cell lung cancer (C-SCLC) is defined as a subgroup of small cell lung cancers (SCLC), which accounts for 2-28 % of all SCLC [1][2][3][4]. According to the NCCN guidelines, the diagnosis of C-SCLC is based on the result that any non-small cell components are more than 10 % of the SCLC tumors [5].…”

Relationship Between the SER Treatment Period and Prognosis of Patients with Small Cell Lung Cancer

“…In general, patients were treated with "sandwich treatment", namely "induction chemother apy+radiotherapy+consolidate chemotherapy" (Tsujino et al, 2014). Standard combination chemotherapy regimens were "VP-16+DDP" recommended by the NCCN guidelines, according to the tolerance to chemotherapy in patients with 4-6 cycles (Ha et al, 2013;Zhang et al, 2014). In view of the important significance of PCI on the prognosis of patients with small cell lung cancer, patients who reach CR by the treatment of radiotherapy and chemotherapy should accepted PCI (25Gy/10F/2W) (Simon et al, 2007).…”