Randomized trial of radiotherapy to the thorax in limited small-cell carcinoma of the lung treated with multiagent chemotherapy and elective brain irradiation: a preliminary report

Journal Article · Thu Nov 01 04:00:00 EST 1984 · J. Clin. Oncol.; (United States)

OSTI ID:5615336

Perez, C A; Einhorn, L; Oldham, R K; Greco, F A; Cohen, H J; Silberman, H; Krauss, S; Hornback, N; Comas, F; Omura, G

A total of 304 patients with limited small-cell carcinoma of the lung were treated with a combination of cyclophosphamide, Adriamycin, and vincristine (CAV) and elective brain irradiation (3,600 rad TD in 14 fractions). The patients were randomized to either receive or not receive thoracic irradiation (4000 rad TD, split course). Of the 304 patients, 291 were eligible for the study. Two hundred eighteen (75%) were completely evaluable. In each group, 81% of the patients had a Karnofsky index of 80% or higher and 14% had supraclavicular or scalene lymph nodes. Patients treated with CAV and no thoracic irradiation had a complete response (CR) of 48%, in contrast to 63% for those receiving chest irradiation. In the first group, the complete and partial response rate was 70%; in the second, 80%. The median survival for the eligible patients treated with CAV and brain radiation therapy was 49 weeks; for those treated with the same regimen plus thoracic irradiation, the median survival was 60 weeks. The actuarial two-year tumor-free survival is 19% in the first group and 28% in the second group. The median survival for the responders in the CAV plus brain irradiation group was 57 weeks and for those receiving thoracic irradiation, 78 weeks. Thoracic failure was 52% in patients not treated with thoracic radiation therapy v 36% in those receiving it (P . .06). The distant metastases incidence was 23% in patients not treated with thoracic radiation and 35% in patients treated with thoracic radiation. Hematologic toxicity was comparable in both groups; 30% of the patients had moderate to severe granulocytopenia and 6%, low homoglobin. Two toxicity-related deaths occurred (one in each group). Moderate gastrointestinal toxicity was noted in 41% and severe in 16% of the patients receiving CAV and brain irradiation without thoracic radiotherapy v 44% and 20% in those irradiated in the thorax.

• Research Organization: Mallinckrodt Inst. of Radiology, St. Louis, MO
• OSTI ID: 5615336
• Journal Information: J. Clin. Oncol.; (United States), Journal Name: J. Clin. Oncol.; (United States) Vol. 2:11; ISSN JCOND
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
560151 -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ALKYLATING AGENTS
ANTI-INFECTIVE AGENTS
ANTIBIOTICS
ANTINEOPLASTIC DRUGS
BODY
BODY AREAS
BRAIN
CARCINOMAS
CENTRAL NERVOUS SYSTEM
CHEMOTHERAPY
CHEST
DISEASES
DOXORUBICIN
DRUGS
ENDOXAN
FRACTIONATED IRRADIATION
IMMUNOSUPPRESSIVE DRUGS
IRRADIATION
LUNGS
MEDICINE
METASTASES
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
SURVIVAL TIME
THERAPY