Phase II study of cyclophosphamide, doxorubicin, and vincristine (CAV) and etoposide plus cisplatin (EP) alternating chemotherapy combined with radiotherapy in small cell lung cancer.
- Author:
Yong Joon PARK
1
;
Eun Hee KOH
;
Joohang KIM
;
Jae Kyung ROH
;
Joon CHANG
;
Chul Min AHN
;
Hee Young SOHN
;
Sung Kyu KIM
;
Won Young LEE
;
Kiho KIM
;
Chang Ok SUH
;
Gwi Eon KIM
;
John J K LOH
;
Byung Soo KIM
Author Information
- Publication Type:Original Article
- Keywords: Alternating chemotherapy; small cell lulng cancer; limited disease; extensive disease
- MeSH: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Carcinoma, Small Cell/drug therapy/*radiotherapy; Cisplatin/*therapeutic use; Combined Modality Therapy; Cyclophosphamide/therapeutic use; Doxorubicin/therapeutic use; Drug Evaluation; Female; Human; Lung Neoplasms/drug therapy/*radiotherapy; Male; Middle Age; Vincristine/therapeutic use
- From:Yonsei Medical Journal 1989;30(1):30-37
- CountryRepublic of Korea
- Language:English
- Abstract: The development of drug resistance is the major limiting factor influencing the survival of patients with small cell lung cancer (SCLC). We have thus examined the activity of cyclophosphamide, doxorubicin and vincristine (CAV) alternating with etoposide and cisplatin (EP) in 35 patients with SCLC. The treatment courses were alternated every 3 or 4 weeks. After induction chemotherapy, patients with limited disease (LD) received thoracic radiotherapy (5000 cGy), prophylactic cranial irradiation (3000 cGy) and maintenance chemotherapy and patients with extensive disease (ED) received maintenance chemotherapy only. In this group of 35 patients, 13 had limited disease (LD) and 22 had extensive disease (ED). After completion of the therapy, 100% of the patients with LD achieved complete plus partial remission (CR + PR) and 68% of the patients with ED achieved CR + PR. The median survival time was 66 weeks (15.3 months) in patients with LD and 44 weeks (10.2 months) in patients with ED. The over all survival for patients with LD was superior to that for patients with ED (p less than 0.05). Also, median response duration for patients with LD (35 wks) was longer than that for patients with ED (17 weeks) (p less than 0.05). The primary site was the most vulnerable site to relapse (18 patients). Toxicity was mild to moderate and acceptable, and there were no treatment-related deaths. These results suggest that the alternation of CAV and EP is effective treatment strategy in the management of SCLC. A randomized controlled study will be required to discriminate the actual effect of this alternating regimen.
