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February 27, 1981

Effect of Warfarin on Survival in Small Cell Carcinoma of the LungVeterans Administration Study No. 75

Author Affiliations

From the Veterans Administration Medical Center, White River Junction, Vt (Drs Zacharski and O'Donnell); the Department of Medicine, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Hanover, NH (Drs Zacharski, Cornell, Forcier, and O'Donnell); the Cooperative Studies Program Coordinating Center, VA Medical Center, Hines, III, and the Department of Clinical Pharmacology and Therapeutics, Loyola University School of Medicine, Maywood, III (Dr Henderson); the VA Medical Center, Newington, Conn, and the Department of Medicine, University of Connecticut, School of Medicine, Farmington (Drs Rickles and Edwards); the VA Medical Center and the Department of Medicine and Pharmacology, Case Western Reserve University School of Medicine, Cleveland (Dr Forman): the VA Medical Center, Gainesville, Fla, and Florida State University Medical School, Tallahassee (Dr Headley); the VA Medical Center and the University of Cincinnati Medical School, Cincinnati (Dr Kim); VA Medical Center and the Medical University of South Carolina, Charleston (Dr O'Dell); VA Medical Center and Tulane University Medical School, New Orleans (Dr Tornyos); and VA Medical Center-Lakeside, Chicago, and Northwestern University Medical School, Evanston, III (Dr Kwaan).

JAMA. 1981;245(8):831-835. doi:10.1001/jama.1981.03310330021017

In a controlled, randomized study, survival of patients with small cell carcinoma of the lung (SCCL) was prolonged on addition of warfarin sodium to combination chemotherapy plus radiation therapy. Median survival for 25 control patients was 24 weeks and for 25 warfarin-treated patients was 50 weeks. This difference could not be accounted for by differences between groups in performance status, extent of disease, age, or sex. The survival advantage associated with warfarin administration was observed both for patients with extensive disease and for those who failed to achieve complete or partial remission. The warfarin-treated group also demonstrated a significantly increased time to first evidence of disease progression. These results suggest that warfarin may be useful in the treatment of SCCL and also support the hypothesis that the blood coagulation mechanism may be involved in the growth and spread of cancer in man.

(JAMA 1981;245:831-835)