Limited small cell lung cancer: prognostic significance of a complete response to the induction phase of chemotherapy followed by thoracic irradiation

Radiology. 1991 Mar;178(3):875-8. doi: 10.1148/radiology.178.3.1847240.

Abstract

Limited-stage small cell lung cancer is frequently treated with induction combination chemotherapy (ICC), followed by consolidation with thoracic irradiation. It has been suggested that patients who do not have a complete response to ICC are unlikely to have control of occult distant metastasis and consequently have such a poor prognosis that thoracic irradiation is unlikely to be of benefit. To examine this hypothesis, 48 patients treated on prospective protocols who achieved a complete response to ICC or subsequently to thoracic irradiation were analyzed. Twenty-four patients had a complete response to ICC (CR-ICC), and 24 subsequently converted to complete-response status after thoracic irradiation (CR-TI). The two groups had similar prognostic factors and treatment. Comparing CR-ICC and CR-TI patients, survival was 40% versus 26% at 2 years and 35% versus 4% at 5 years, respectively (P less than .05). Freedom from distant metastasis was 41% at 5 years for the CR-ICC patients and 8% for the CR-TI patients (P less than .05). A modest number of CR-TI patients were long-term survivors, suggesting a value for thoracic irradiation as consolidation therapy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Small Cell / drug therapy
  • Carcinoma, Small Cell / mortality*
  • Carcinoma, Small Cell / radiotherapy
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / radiotherapy
  • Male
  • Middle Aged
  • Prognosis
  • Radiotherapy, High-Energy*
  • Vincristine / administration & dosage

Substances

  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Cisplatin

Supplementary concepts

  • CAV protocol