Abstract | BACKGROUND: METHODS: One hundred nineteen patients were allocated to four cycles of either cyclophosphamide, doxorubicin, and vincristine (CAV) or single-agent carboplatin. Patients had either a Karnofsky performance score < or = 50 and/or a prognostic score indicative of a 1-year survival rate < or = 15%. RESULTS: Grade 3-4 neutropenia and intravenous antibiotic use were significantly more common with the CAV regimen (P < 0.005). Conversely, Grade 3-4 thrombocytopenia was more common (P < 0.0009) and platelet transfusion was more frequent (P < 0.05) with carboplatin therapy. Nonhematologic toxicity was similar in both treatment arms, except for alopecia with CAV therapy (P < 0.0007). Symptom relief occurred in 48% and 41% of patients in the CAV and carboplatin treatment arms, respectively. Dyspnea was improved in 66% and 41% of patients and cough was improved in 21% and 7% of patients in the CAV and carboplatin treatment arms, respectively. CAV therapy produced a higher response rate than carboplatin (38% vs. 25%), but this was not statistically significant (P = 0.15). The median overall survival for patients in the CAV and carboplatin treatment arms was 17 weeks and 15.9 weeks, respectively, with 1-year survival rates of 12% and 6%. CONCLUSIONS: Single-agent carboplatin is a feasible treatment in patients with poor prognosis SCLC and produces response rates, relief of tumor-related symptoms, and survival similar to what is seen in patients who receive CAV chemotherapy. The lower risk of life-threatening sepsis and less need for hospitalization or intravenous antibiotic courses is advantageous in this susceptible patient population.
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Authors | S C White, P Lorigan, M R Middleton, H Anderson, J Valle, Y Summers, P A Burt, A Arance, R Stout, N Thatcher |
Journal | Cancer
(Cancer)
Vol. 92
Issue 3
Pg. 601-8
(Aug 01 2001)
ISSN: 0008-543X [Print] United States |
PMID | 11505405
(Publication Type: Clinical Trial, Clinical Trial, Phase II, Comparative Study, Journal Article, Randomized Controlled Trial)
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Copyright | Copyright 2001 American Cancer Society. |
Chemical References |
- Antineoplastic Agents
- Vincristine
- Doxorubicin
- Cyclophosphamide
- Carboplatin
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Topics |
- Aged
- Antineoplastic Agents
(adverse effects, therapeutic use)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Carboplatin
(adverse effects, therapeutic use)
- Carcinoma, Small Cell
(drug therapy, mortality)
- Cyclophosphamide
(adverse effects, therapeutic use)
- Doxorubicin
(adverse effects, therapeutic use)
- Female
- Humans
- Lung Neoplasms
(drug therapy, mortality)
- Male
- Middle Aged
- Prognosis
- Survival Analysis
- Vincristine
(adverse effects, therapeutic use)
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