skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus

Abstract

There are sound radiobiologic and suggestive clinical rationale for superfractionating the radiotherapeutic regimens employed for the therapy of rapidly growing malignancies. Oat cell carcinoma of the bronchus is such a tumor. The authors report their experience combining aggressive systemic combination chemotherapy with supperfractionated radiotherapy for the treatment of limited oat cell carcinoma of the bronchus. Overall, patient tolerance was satisfactory and a complete remission rate of 74% was achieved. It remains to be proven, in a prospective randomized fashion, whether this approach is superior to current conventional management.

Authors:
; ; ;
Publication Date:
Research Org.:
Univ. of Manitoba, Winnipeg
OSTI Identifier:
6268459
Resource Type:
Journal Article
Resource Relation:
Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States); Journal Volume: 10:10
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; BRONCHI; BIOLOGICAL RADIATION EFFECTS; FIBROSIS; RADIOINDUCTION; IMMUNOSUPPRESSION; RADIOTHERAPY; SIDE EFFECTS; CARCINOMAS; CHEMOTHERAPY; COBALT 60; ENDOXAN; FRACTIONATED IRRADIATION; GAMMA RADIATION; NITROSOUREAS; ONCOVIN; PATIENTS; X RADIATION; ALKALOIDS; ALKYLATING AGENTS; ANTIMITOTIC DRUGS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BIOLOGICAL EFFECTS; COBALT ISOTOPES; DISEASES; DRUGS; ELECTROMAGNETIC RADIATION; IMMUNOSUPPRESSIVE DRUGS; INTERMEDIATE MASS NUCLEI; INTERNAL CONVERSION RADIOISOTOPES; IONIZING RADIATIONS; IRRADIATION; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; MINUTES LIVING RADIOISOTOPES; NEOPLASMS; NITROSO COMPOUNDS; NUCLEAR MEDICINE; NUCLEI; ODD-ODD NUCLEI; ORGANIC COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; PATHOLOGICAL CHANGES; RADIATION EFFECTS; RADIATIONS; RADIOISOTOPES; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY; YEARS LIVING RADIOISOTOPES; 560151* - Radiation Effects on Animals- Man; 550603 - Medicine- External Radiation in Therapy- (1980-)

Citation Formats

Hodson, D.I., Malaker, K., Meikle, A.L., and Levitt, M. Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus. United States: N. p., 1984. Web. doi:10.1016/0360-3016(84)90275-X.
Hodson, D.I., Malaker, K., Meikle, A.L., & Levitt, M. Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus. United States. doi:10.1016/0360-3016(84)90275-X.
Hodson, D.I., Malaker, K., Meikle, A.L., and Levitt, M. Mon . "Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus". United States. doi:10.1016/0360-3016(84)90275-X.
@article{osti_6268459,
title = {Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus},
author = {Hodson, D.I. and Malaker, K. and Meikle, A.L. and Levitt, M.},
abstractNote = {There are sound radiobiologic and suggestive clinical rationale for superfractionating the radiotherapeutic regimens employed for the therapy of rapidly growing malignancies. Oat cell carcinoma of the bronchus is such a tumor. The authors report their experience combining aggressive systemic combination chemotherapy with supperfractionated radiotherapy for the treatment of limited oat cell carcinoma of the bronchus. Overall, patient tolerance was satisfactory and a complete remission rate of 74% was achieved. It remains to be proven, in a prospective randomized fashion, whether this approach is superior to current conventional management.},
doi = {10.1016/0360-3016(84)90275-X},
journal = {Int. J. Radiat. Oncol., Biol. Phys.; (United States)},
number = ,
volume = 10:10,
place = {United States},
year = {Mon Oct 01 00:00:00 EDT 1984},
month = {Mon Oct 01 00:00:00 EDT 1984}
}
  • Twenty-three patients with metastatic non-oat cell bronchogenic carcinoma (MN0BC) were treated with cyclophosphamide, adriamycin, methotrexate,and procarbazine (CAMP) after radiation therapy. Objective responses were seen in 11 of 23 patients (48%) with a projected median survival time of 12.5 months for responding patients and patients with stable disease. Lung, liver, and cutaneous sites of involvement proved to be highly responsive; bone involvement was less responsive. CAMP is an effective combination in the treatment of MNOBC and its use in patients with less advanced disease should be explored.
  • A 27-year-old woman with Hodgkin's disease, nodular sclerosing type, having received two courses of radiation therapy with one year and nine months interval and a prolonged course of chemotherapy with combinations of COPP, MOPP, and CVPP, developed oat cell carcinoma of the lung, four years after the initial diagnosis.
  • From March 1982, 31 patients with stage IV non-oat cell lung cancer have been treated. Radiotherapy was given as three 2.00-Gy fractions on Days 1 and 2, 8 and 9, 22 and 23, and 29 and 30, for a total dose of 48 Gy over a 30-32-day treatment period. A three-drug combination of cyclophosphamide (400 mg/m2), doxorubicin (17 mg/m2), and methotrexate (15 mg/m2) was given on Days 3 and 24 and repeated thereafter every 21 days. Three of 31 evaluable patients (10%) achieved objective complete response and 18 of 31 (58%) achieved partial response (ie, regression of 50%-90%), while nomore » change or disease progression was observed in ten of 31 (32%). The overall response rate in our study was 68%, which is a response much higher than other results in extensive disease. However, controlled trials will be necessary to definitively establish the superiority of this regimen to conventional trials. There was a significant shift of performance status towards higher values after treatment: 12 of the 27 patients classified in the 70-80 Karnofsky category before treatment moved to the higher category, 13 remained in the same status, and only two shifted to the worst category, indicating that the treatment had been effective in giving patients a better quality of life during their survival. The median survival was 35 weeks for the entire group of patients and 44 and 15 weeks for the responders and nonresponders, respectively. One of the primary findings of this pilot study was the ability to give one course of 12 Gy of radiation as multiple fractions per day during each of the first 2 weeks of treatment alternated with one course of chemotherapy, with most patients having very mild or no side effects.« less
  • Twenty-eight patients with Stage III or IV ovarian carcinoma were treated with combined chemotherapy-radiotherapy employing a unique protocol. Four cycles of cyclophosphamide and hexamethylmelamine alternated with four cycles of concurrent cisplatin, whole abdominal radiotherapy, and intraperitoneal misonidazole. The entire treatment program lasted six months. Clinical complete responses were seen in 50% of the patients with an overall response rate of 61%. Pathologic complete response (PCR) confirmed at second look surgery occurred in 18% of the group (5 patients). Median survival of the entire group was 15.2 months with all PCR's alive NED. This outcome was no different than our previousmore » experience with combination chemotherapy alone. Toxicities seen included leukopenia, thrombocytopenia, nausea, vomiting, and weight loss. However, these side effects were manageable. Two non-tumor deaths occurred. This study demonstrates the feasibility of combining drug and radiation therapy concurrently in the treatment of ovarian cancer; further research is needed to explore different sequencing and dose levels that could improve the outcome.« less
  • Between October 1974 and December 1980, 123 patients with limited small cell carcinoma were treated in the Indiana University Medical Center Department of Radiation Oncology. Of these, 115 were treated with preplanned combined modality therapy using irradiation and polychemotherapy (Adriamycin, Cytoxan and Oncovin). All patients received whole brain prophylactic irradiation and were followed a minimum of 2 years. Sixty-six patients were given chest irradiation with all but two receiving 3500-4000 rad while 49 did not receive this treatment. Sixty-five percent of those patients receiving chest irradiation had a complete response to therapy, as opposed to 33% who did not. Thismore » study demonstrates an increase response rate, median survival, and overall survival in patients receiving chest irradiation. The high rate of relapse in the chest suggests the need for more effective control of the primary. This may be accomplished by increasing the dose of chest irradiation or surgical removal when feasible.« less