Journal of Clinical Oncology, Vol 8, 892-898, Copyright © 1990 by American Society of Clinical Oncology
Concurrent chemotherapy/radiotherapy for limited small-cell lung carcinoma: a Southwest Oncology Group Study
JD McCracken, LM Janaki, JJ Crowley, SA Taylor, PG Giri, GB Weiss, W Gordon Jr, LH Baker, A Mansouri and JP Kuebler
Brooke Army Medical Center, Ft Sam Houston, TX.
The Southwest Oncology Group (SWOG) has conducted a phase II study to
explore the efficacy and toxicity of initial, concurrent use of radiation
therapy with cisplatin, etoposide (VP-16), and vincristine in limited-stage
small-cell carcinoma of the lung. Two courses of cisplatin, VP-16, and
vincristine chemotherapy were given with concurrent radiotherapy (XRT) to
the primary tumor to a total dose of 4,500 cGy. Elective brain XRT was
given to all patients concurrent with a third course of cisplatin/VP-16
therapy. Consolidation chemotherapy consisting of vincristine,
methotrexate, and VP-16 alternating with Adriamycin (doxorubicin; Adria
Laboratories, Columbus, OH) and cyclophosphamide, was given for 12 weeks
following the initial induction chemotherapy/XRT program. Patients with a
complete response had all therapy discontinued. Among 154 eligible patients
treated, the complete response rate was 56%, with a partial response rate
of 27%. The median survival is 17.5 months with an estimated 30% survival
rate at 4 years from initiation of treatment. Combined modality toxicities
were acceptable with the predominant toxicity being moderate to severe
leukopenia and mild radiation esophagitis. The results of this treatment
program appear superior to any previously reported by our group and compare
favorably to those in the literature at large.
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