[Skip to Content]
[Skip to Content Landing]
Article
March 1981

Combined Modality Treatment of Small Cell Carcinoma of the Lung

Author Affiliations

From the Departments of Medicine (Drs Feld, Evans, Quirt, Curtis, and Baker), Radiation Oncology (Drs Pringle, Keen, and Yeoh), and Pathology (Dr Brown), University of Toronto; and the Department of Biostatistics, Ontario Cancer Institute, Toronto (Dr Deboer).

Arch Intern Med. 1981;141(4):469-473. doi:10.1001/archinte.1981.00340040065019
Abstract

• Ninety patients with extensive and 61 with limited small cell carcinoma of the lung were treated with three courses of intravenous chemotherapy (cyclophosphamide, doxorubicin hydrochloride, and vincristine sulfate) followed by radiotherapy to intrathoracic disease, and a second three-drug oral combination consisting of lomustine, procarbazine, and methotrexate for one year. Among the 147 patients who were evaluated, 55 of 66 (83%) with limited disease and 53 of 81 (65%) with extensive disease showed response after three courses of chemotherapy. The complete response rate in patients with limited disease prior to radiotherapy was 24%, but increased to 58% when evaluated following radiotherapy. The median survival was 47 weeks for patients with limited disease and 36 weeks for those with extensive disease. A 24% two-year survival is projected for complete responders. Important prognostic factors for survival are performance status, extent of disease, and sex, with female subjects doing somewhat better than male subjects. Among patients with limited disease, 45% failed within the CNS despite the use of chemotherapeutic agents that cross the blood-brain barrier. The initial induction regimen and radiotherapy were well tolerated; the oral three-drug combination was more toxic and did not prevent CNS metastases.

(Arch Intern Med 1981;141:469-473)

×