ISSN:
1569-8041
Keywords:
brain metastases
;
combined modality
;
dose intensification
;
limited disease
;
local control
;
small-cell lung cancer
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: The role of chemotherapy dose-intensification in small-cell lung cancer (SCLC) remains unclear. This phase I–II study evaluates feasibility and outcome of combination chemotherapy at moderately elevated doses with concomitant thoracic radiotherapy in limited-disease SCLC. Patients and methods: Moderately elevated doses of ifosfamide–epirubicin (cycles 1 and 3) and of carboplatin–etoposide (cycles 2 and 4) were given with G-CSF and peripheral blood stem-cell (PBSC) support. Thoracic radiotherapy (40 Gy) was given once daily during the first five days of each cycle. Results: Overal toxicity was acceptable; most common side-effects were myelosuppression and asthenia. All 35 eligible patients responded (23 CR, 12 PR). Median time to progression was 15 months; median overall survival was 24.6 months. Only 6 of 25 relapsing patients (24%) presented with a locoregional recurrence while 12 of 25 (48%) relapsed in the central nervous system (CNS). Conclusions: This regimen is a feasible dose-intensification with an acceptable toxicity profile. Its efficacy was demonstrated by a 100% response rate, an excellent local tumor control rate and a median survival of 24.6 months. In the absence of PCI, CNS relapse is a major problem if adequate local control is achieved.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008306732232
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