Journal of Clinical Oncology, Vol 4, 4-13, Copyright © 1986 by American Society of Clinical Oncology

ARTICLES

High-dose intensification therapy with autologous bone marrow support for limited small-cell bronchogenic carcinoma

G Spitzer, P Farha, M Valdivieso, K Dicke, A Zander, L Vellekoop, WK Murphy, HM Dhingra, T Umsawasdi and D Chiuten

The efficacy and toxicity of high-dose chemotherapy with autologous bone marrow transplantation (ABMT) was studied in 32 patients with untreated limited small-cell bronchogenic carcinoma (SCBC). Ten patients received three courses of induction therapy consisting of vincristine (VCR) (1.5 mg X 2), ifosfamide (5 g/m2), and Adriamycin (Ad; Adria Laboratories, Columbus, Ohio) (60 mg/m2). Patients then received two courses of intensification therapy with cyclophosphamide (CYT) (4.5 g/m2), 4' demethyl-epipodophyllotoxin-d-D-ethylidene glucoside (VP-16-213) (600 mg/m2) and VCR (2 mg) with ABMT. Another 22 patients received induction therapy with VCR, CYT (600 mg/m2), Ad (50 mg/m2), and VP-16-213 (180 mg/m2). All 22 patients also received intensification therapy of the same dose of CYT (4.5 g/m2) and VP-16- 213 (600 mg/m2). Nine patients also received high-dose methotrexate (MTX), four patients received Ad (40 to 60 mg/m2), and two patients received both Ad and MTX. After intensification, patients received elective prophylactic brain irradiation (3,000 rad) and chest irradiation (5,000 rad). After induction therapy, there were 13 (41%) complete remissions (CR) and 17 (53%) partial remissions (PR). After intensification therapy, there were 22 CRs (69%) and 10 PRs (31%). Median survival for all patients was 14 months (range, 5 to 59+). Of the 13 patients who received intensification therapy in CR, five remain disease free (DF), four for 4 years or longer. Of the nine patients to achieve CR with intensification, only one is DF. No patient died during intensification. In conclusion, intensification with high-dose chemotherapy can increase the CR rate, and this approach is most likely to show long-term benefits in patients with minimal disease (CR) at the beginning of intensification therapy.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G. Crivellari, S. Monfardini, S. Stragliotto, D. Marino, and S. M. L. Aversa Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses Oncologist, January 1, 2007; 12(1): 79 - 89. [Abstract] [Full Text] [PDF]

				P Pedrazzoli, J. Ledermann, J-P Lotz, S Leyvraz, M Aglietta, G Rosti, K. Champion, S Secondino, F Selle, N Ketterer, et al. High dose chemotherapy with autologous hematopoietic stem cell support for solid tumors other than breast cancer in adults Ann. Onc., October 1, 2006; 17(10): 1479 - 1488. [Abstract] [Full Text] [PDF]

				S. G. Spiro and J. C. Porter Lung Cancer--Where Are We Today?: Current Advances in Staging and Nonsurgical Treatment Am. J. Respir. Crit. Care Med., November 1, 2002; 166(9): 1166 - 1196. [Abstract] [Full Text] [PDF]

				K. Osterlind Chemotherapy in small cell lung cancer Eur. Respir. J., December 1, 2001; 18(6): 1026 - 1043. [Abstract] [Full Text] [PDF]

				A. Elias Hematopoietic Stem Cell Transplantation for Small Cell Lung Cancer* Chest, December 1, 1999; 116 (2009): 531S - 538S. [Abstract] [Full Text] [PDF]

				B. D. Cheson, L. Lacerna, B. Leyland-Jones, G. Sarosy, and R. E. Wittes Autologous Bone Marrow Transplantation: Current Status and Future Directions Ann Intern Med, January 1, 1989; 110(1): 51 - 65. [Abstract] [PDF]