Abstract
This report gives the complete findings at one year of a study comparing radiotherapy (Rt) with radiotherapy followed by 3-drug chemotherapy (RtC3) in the treatment of histologically proven small-cell carcinoma of the lung of limited extent. Over the 12-month period there was a significantly increased survival for the RtC3 patients (P = 0.002) and at 12 months 18% of the 121 Rt but 34% of the 115 RtC3 patients were alive (P = 0.009). The median survival for the Rt series was 25 weeks and for the RtC3 series 43 weeks. There was evidence of recurrence of the primary cancer in 32 (32%) of the 99 Rt and 20 (26%) of the 76 RtC3 patients who died. Distant metastases appeared earlier and were more frequent in the Rt series (P less than 0.0001) and over the 12-month period 79% of the Rt and 57% of the RtC3 patients developed distant metastases (P less than 0.0005). At 12 months only 8% of the Rt but 26% of the RtC3 patients were alive and free of metastases. Adverse reactions occurred much more frequently in the RtC3 series; 32% of the Rt series as against 83% of the RtC3 series had reactions, the most common being nausea and vomiting (13% Rt, 71% RtC3) and the most serious being marrow depression (23% Rt, 54% RtC3). No important differences were found among the survivors in the 2 series at 3, 6 or 12 months, in general condition, physical activity or respiratory function. It is concluded that radiotherapy plus chemotherapy was superior to radiotherapy alone, although chemotherapy did not protect patients from recurrence of primary growth.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alexander M., Glatstein E. J., Gordon D. S., Daniels J. R. Combined modality treatment for oat cell carcinoma of the lung: a randomized trial 1,2,3. Cancer Treat Rep. 1977 Jan-Feb;61(1):1–6. [PubMed] [Google Scholar]
- Bergsagel D. E., Jenkin R. D., Pringle J. F., White D. M., Fetterly J. C., Klaassen D. J., McDermot R. S. Lung cancer: clinical trial of radiotherapy alone vs. radiotherapy plus cyclophosphamide. Cancer. 1972 Sep;30(3):621–627. doi: 10.1002/1097-0142(197209)30:3<621::aid-cncr2820300305>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
- Broder L. E., Cohen M. H., Selawry O. S. Treatment of bronchogenic carcinoma. II. Small cell. Cancer Treat Rev. 1977 Dec;4(4):219–260. doi: 10.1016/s0305-7372(77)80001-7. [DOI] [PubMed] [Google Scholar]
- Bunn P. A., Jr, Cohen M. H., Ihde D. C., Fossieck B. E., Jr, Matthews M. J., Minna J. D. Advances in small cell bronchogenic carcinoma. Cancer Treat Rep. 1977 May-Jun;61(3):333–342. [PubMed] [Google Scholar]
- Deeley T. J. A clinical trial to compare two different tumour dose levels in the treatment of advanced carcinoma of the bronchus. Clin Radiol. 1966 Jul;17(3):299–301. doi: 10.1016/s0009-9260(66)80041-7. [DOI] [PubMed] [Google Scholar]
- Durrant K. R., Berry R. J., Ellis F., Ridehalgh F. R., Black J. M., Hamilton W. S. Comparison of treatment policies in inoperable bronchial carcinoma. Lancet. 1971 Apr 10;1(7702):715–719. doi: 10.1016/s0140-6736(71)91986-6. [DOI] [PubMed] [Google Scholar]
- Eagan R. T., Maurer L. H., Forcier R. J., Tulloh M. Combination chemotherapy and radiation therapy in small cell carcinoma of the lung. Cancer. 1973 Aug;32(2):371–379. doi: 10.1002/1097-0142(197308)32:2<371::aid-cncr2820320213>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
- Fox W., Scadding J. G. Medical Research Council comparative trial of surgery and radiotherapy for primary treatment of small-celled or oat-celled carcinoma of bronchus. Ten-year follow-up. Lancet. 1973 Jul 14;2(7820):63–65. doi: 10.1016/s0140-6736(73)93260-1. [DOI] [PubMed] [Google Scholar]
- Hansen H. H., Muggia F. M., Andrews R., Selawry O. S. Intensive combined chemotherapy and radiotherapy in patients with nonresectable bronchogenic carcinoma. Cancer. 1972 Aug;30(2):315–324. doi: 10.1002/1097-0142(197208)30:2<315::aid-cncr2820300202>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
- Hansen H. H., Selawry O. S., Simon R., Carr D. T., van Wyk C. E., Tucker R. D., Sealy R. Combination chemotherapy of advanced lung cancer: a randomized trial. Cancer. 1976 Dec;38(6):2201–2207. doi: 10.1002/1097-0142(197612)38:6<2201::aid-cncr2820380602>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
- Host H. Cyclophosphamide (NSC-26271) as adjuvant to radiotherapy in the treatment of unresectable bronchogenic carcinoma. Cancer Chemother Rep 3. 1973 Mar;4(2):161–164. [PubMed] [Google Scholar]
- Livingston R. B. Nitrosourea combinations in lung cancer. Cancer Treat Rep. 1976 Jun;60(6):757–760. [PubMed] [Google Scholar]