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Title: Upper hemibody and local chest irradiation as consolidation following response to high-dose induction chemotherapy for small cell bronchogenic carcinoma--a pilot study

Abstract

Fourteen patients with small cell bronchogenic carcinoma, five with extensive disease and nine with localized disease, were treated with cyclophosphamide (1.5 g/m2 iv, Days 1 and 22), lomustine (70 mg/m2 orally, Day 1), and methotrexate (15 mg/m2 twice weekly during Weeks 2, 3, 5, and 6). UHBI (600 rads) was given during Week 6 in a single dose and LCI was given during Week 7 (2000 rads/five fractions) to the tumor and mediastinum. Maintenance chemotherapy began in Week 12 with cyclophosphamide (700 mg/m2 iv every 3 weeks) and lomustine (70 mg/m2 orally every 6 weeks). Twelve patients were evaluable for response and toxicity (eight with limited disease). There were three complete response and seven partial responses after induction chemotherapy. After completion of the consolidation radiation therapy, all 12 patients had a response: six complete responses and six partial responses. Acute toxic effects included nausea and vomiting in eight patients, fever in five, and hypotension and angina in one. Subacute toxic effects included nausea, vomiting, and dehydration in two patients who required hospitalization, prolonged aplasia in one, reversible radiation esophagitis in three. Three patients had radiation pneumonitis including one with bilateral diffuse disease that led to death from respiratory failure. Onlymore » two of 12 patients received their maintenance therapy on schedule. Treatment failures occurred within the LCI field in seven patients and in distant metastatic sites in six. The median time to first relapse was 7 months and the median survival was 9 months. Because of toxicity, treatment delays, and poor survival in this group of patients, we cannot recommend this combined modality approach.« less

Authors:
; ; ;
Publication Date:
Research Org.:
Department of Medicine, American Oncologic Hospital, Philadelphia
OSTI Identifier:
6376016
Resource Type:
Journal Article
Journal Name:
Conn. Med.; (United States)
Additional Journal Information:
Journal Volume: 66:8
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 59 BASIC BIOLOGICAL SCIENCES; 63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; CARCINOMAS; BIOLOGICAL RADIATION EFFECTS; CHEMOTHERAPY; SIDE EFFECTS; LOCAL IRRADIATION; ANTINEOPLASTIC DRUGS; BRONCHI; PATIENTS; RADIATION DOSES; RADIOINDUCTION; TOXICITY; BIOLOGICAL EFFECTS; DISEASES; DOSES; DRUGS; IRRADIATION; NEOPLASMS; RADIATION EFFECTS; RESPIRATORY SYSTEM; THERAPY; 550603* - Medicine- External Radiation in Therapy- (1980-); 550900 - Pathology; 560151 - Radiation Effects on Animals- Man

Citation Formats

Mason, B A, Richter, M P, Catalano, R B, and Creech, R B. Upper hemibody and local chest irradiation as consolidation following response to high-dose induction chemotherapy for small cell bronchogenic carcinoma--a pilot study. United States: N. p., 1982. Web.
Mason, B A, Richter, M P, Catalano, R B, & Creech, R B. Upper hemibody and local chest irradiation as consolidation following response to high-dose induction chemotherapy for small cell bronchogenic carcinoma--a pilot study. United States.
Mason, B A, Richter, M P, Catalano, R B, and Creech, R B. 1982. "Upper hemibody and local chest irradiation as consolidation following response to high-dose induction chemotherapy for small cell bronchogenic carcinoma--a pilot study". United States.
@article{osti_6376016,
title = {Upper hemibody and local chest irradiation as consolidation following response to high-dose induction chemotherapy for small cell bronchogenic carcinoma--a pilot study},
author = {Mason, B A and Richter, M P and Catalano, R B and Creech, R B},
abstractNote = {Fourteen patients with small cell bronchogenic carcinoma, five with extensive disease and nine with localized disease, were treated with cyclophosphamide (1.5 g/m2 iv, Days 1 and 22), lomustine (70 mg/m2 orally, Day 1), and methotrexate (15 mg/m2 twice weekly during Weeks 2, 3, 5, and 6). UHBI (600 rads) was given during Week 6 in a single dose and LCI was given during Week 7 (2000 rads/five fractions) to the tumor and mediastinum. Maintenance chemotherapy began in Week 12 with cyclophosphamide (700 mg/m2 iv every 3 weeks) and lomustine (70 mg/m2 orally every 6 weeks). Twelve patients were evaluable for response and toxicity (eight with limited disease). There were three complete response and seven partial responses after induction chemotherapy. After completion of the consolidation radiation therapy, all 12 patients had a response: six complete responses and six partial responses. Acute toxic effects included nausea and vomiting in eight patients, fever in five, and hypotension and angina in one. Subacute toxic effects included nausea, vomiting, and dehydration in two patients who required hospitalization, prolonged aplasia in one, reversible radiation esophagitis in three. Three patients had radiation pneumonitis including one with bilateral diffuse disease that led to death from respiratory failure. Only two of 12 patients received their maintenance therapy on schedule. Treatment failures occurred within the LCI field in seven patients and in distant metastatic sites in six. The median time to first relapse was 7 months and the median survival was 9 months. Because of toxicity, treatment delays, and poor survival in this group of patients, we cannot recommend this combined modality approach.},
doi = {},
url = {https://www.osti.gov/biblio/6376016}, journal = {Conn. Med.; (United States)},
number = ,
volume = 66:8,
place = {United States},
year = {Sun Aug 01 00:00:00 EDT 1982},
month = {Sun Aug 01 00:00:00 EDT 1982}
}