Oat cell carcinoma of the lung.Early treatment results of combination radiation therapy and chemotherapy

Abstract

Since August 1974, 50 patients with histologically proven oat cell carcinoma of the lung were treated at Indiana University Hospitals with a combination of adriamycin, cyclophosphamide, Oncovin, BCG immunotherapy, and radiation therapy to the primary lung tumor and whole brain. Twenty‐nine patients are eligible for a 6‐month follow‐up and are included in this report. All 29 patients responded to therapy; 12 patients (41%) had a minimum of 50% reduction in tumor mass and 17 patients (59%) had complete clinical remission of disease. Eight (38%) of the 29 patients have remained in complete remission from 6 to 14 months, and 90% of the patients survived a minimum of 6 months. This represents a considerable improvement in survival rates over what had been obtained at Indiana University Hospitals previously.

Oat Cell Carcinoma of the Larynx

“…Although these regimens entail considerable side effects, their effect on the natural course of lung lesions has been dramatic. Hornback, et al, 8 for example, have employed a protocol that includes adriamycin, vincristine, cyclophosphamide, immunotherapy (BCG) and irradiation. Seven of eight patients staged as having limited disease were found to have complete response to treatment, i.e., disappearance of any evidence of disease during an admittedly short period of follow-up.…”

Radiation Therapy in the Management of Carcinoma of the Lung

“…Adjuvant chemotherapy has demonstrated significant effectiveness in inducing regression in small cell undifferentiated carcinoma but has been shown to be of minimal value in patients with nonoat cell bronchogenic carcinoma. 11,22,23 This is related to the cell kinetics of these tumors. 33,45 Small cell carcinoma of the lung is sensitive to irradiation.…”

Integrale Behandlung (Chemo- und Radiotherapie) des inoperablen Bronchialkarzinoms

“…Die mittlere Uberlebenszeit konnte zwar auf 32 bis 36 Wochen verlängert werden, jedoch wurde bald klar, daß bei alleiniger Chemotherapie Lokalrezidive den Behandlungserfolg schmälerten. Fast alle neuen Programme zur Therapie des kleinzelligen Bronchialkarzinoms enthalten daher eine zusätzliche Bestrahlung auf primäre Tumorlokalisationen, Mediastinum und Hili (4,7,12,17,18,30,32,36,37 (17,19,20). Analysen von Remissionsraten und Uberlebenszeiten sind jedoch nur dann vergleichbar, wenn ähnliche Verteilungen der prognostisch wichtigen Faktoren von Ausbreitungs-und Aligemeinstatus vorliegen (13).…”

“…Durch Polychemotherapie sind beim kleinzelligen Bronchialkarzinom auf ambulanter Basis 50% der Fälle in klinische Vollremission zu bringen. Die Kombination von Vincristin, Adriamycin und Cyclophosphamid scheint nach unseren und anderen Studien (17,19,20) In Fällen mit lokoregionaler (einseitiger) Ausbreitung (Kategorie A) scheint im Anschluß an die letzte Chemotherapie eine zweite Strahlentherapieserie auf die Tumorregion (bis zur Gesamtdosis von 4500 rad Herddosis) günstig zu sein (17,30). Bei den Kategorien B und C sollten weitere Bestrahlungen jedoch nur unter palliativen Gesichtspunkten bei Venen-oder (8,10,22).…”