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Addition of etoposide to cyclophosphamide, doxorubicin, and vincristine for remission induction and survival in patients with small cell lung cancer.

Abstract
A total of 116 patients with small cell lung cancer were randomized to receive either: cyclophosphamide, 750 mg/m2, doxorubicin, 50 mg/m2, and vincristine, 2 mg iv (Regimen A), or the same drugs plus etoposide, 100 mg/m2 iv daily for 2 days (Regimen B) every 3 weeks. Complete responders received whole-brain radiation therapy. The overall response rates were 50% for Regimen A and 65% for Regimen B (P less than 0.05). The complete response rates were 18% for Regimen A and 44% for Regimen B (P less than 0.01). For patients with limited disease, the complete responders were 35% on Regimen A and 52% on Regimen B (P = 0.26); for those with extensive disease, the complete responders were 0% on Regimen A and 35% on Regimen B (P = 0.002). The median survival for complete responders was 17 months on Regimen A and 20 months on Regimen B. The difference is not statistically significant. Toxicity was tolerable for both groups; however, it was greater for the etoposide arm. We conclude that although etoposide improves the overall response rates in patients with small cell lung cancer, especially those with extensive disease, the addition of this drug does not lead to improved survival.
AuthorsA A Messeih, J M Schweitzer, A Lipton, H A Harvey, M A Simmonds, J A Stryker, J A Ricci, S L Hoffman, R J Gottleib, R H Dixon
JournalCancer treatment reports (Cancer Treat Rep) Vol. 71 Issue 1 Pg. 61-6 (Jan 1987) ISSN: 0361-5960 [Print] United States
PMID3024828 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
Topics
  • Actuarial Analysis
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Brain Neoplasms (secondary)
  • Carcinoma, Small Cell (drug therapy, mortality, radiotherapy)
  • Cyclophosphamide (administration & dosage)
  • Doxorubicin (administration & dosage)
  • Etoposide (administration & dosage)
  • Female
  • Humans
  • Lung Neoplasms (drug therapy, mortality, radiotherapy)
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Random Allocation
  • Vincristine (administration & dosage)

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