Intensive combined chemotherapy and radiotherapy in patients with nonresectable bronchogenic carcinoma

Abstract

A treatment program utilizing combinations of antineoplastic agents was evaluated in 46 unresectable untreated patients with bronchogenic carcinoma. Following specific staging procedures, patients considered to have “limited” disease apparently confined to one hemithorax and ipsilateral supraclavicular area were treated, in addition, with cobalt‐60 radiotherapy, receiving 5000 R in a 6‐week period. The median survival for patients with “limited” disease was 13 months with 9 of 27 patients (33%) currently alive, vs. 4 months for patients with “extensive” disease and with 2 of 17 patients (12%) still alive. Determination of objective response to the combined treatment was possible in 36 patients, and it occurred in 22 (61%). Responders lived significantly longer (median 365 days) than nonresponders (median 130 days). The objective response rate was highest and the survival longest in patients with adenocarcinoma and small cell undifferentiated carcinoma of the lung. The data suggest that the principle of staging and treatment as utilized in the current study might have a place in the management of inoperable lung cancer and contribute to the prolongation of survival.

Ectopic placental proteins in nontrophoblastic tumors.Serial measurements following chemotherapy

“…A greater than 50% reduction in the product of these diameters was defined as regression induced by cheme therapy, if unaccompanied by progression elsewhere or appearance of new lesions. 8 When known liver metastases were present, calipers were used (whenever possible) to measure the distance from costal margin and xiphoid to the liver edge, in the midclavicular line and midline, respectively. A greater than 30% reduction in the sum of two of these measurements was also defined as regression of tumor.…”

Radiotherapy alone or with chemotherapy in the treatment of small-cell carcinoma of the lung.

“…However, both were localized treatments, and not directed at possible distant metastases. When the present study was initiated there was evidence from some studies (Bergsagel et al, 1972;Hansen et al, 1972;Eagan et al, 1973), but not from others (Durrant et al, 1971;H0st, 1973), that cytotoxic drugs, alone or in combination, given in addition to radiotherapy, could improve the survival ofpatients with smallcell carcinoma. The present study was therefore undertaken to examine in a randomized multicentre trial whether, in patients with "limited" disease ( clinical and radiographic evidence, was confined to the mediastinum, the soft tissues of one hemithorax, and the ipsilateral and contralateral scalene and lower cervical nodes.…”

Chemotherapy for carcinoma of the bronchus—a brief review

“…Hansen and his colleagues (Hansen et al, 1972a) have reported on a randomized study of intensive combined chemotherapy in association with radiotherapy for patients with unresectable carcinoma of the bronchus. The treatment schedule was complex, involving a sequence of pairs of chemotherapeutic agents.…”