Superiority of high-dose platinum (cisplatin and carboplatin) compared to carboplatin alone in combination chemotherapy for small-cell lung carcinoma: A prospective randomised trial of 280 consecutive patients
| Autor: | Kell Østerlind, HeineH. Hansen, C. Kristensen, S. Ingeberg, P. Grundtvig Sorensen, P Dombernowsky, Fred R. Hirsch, N. Jeppesen |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms Urology Small-cell carcinoma Carboplatin chemistry.chemical_compound Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies Carcinoma Small Cell Infusions Intravenous Cyclophosphamide Survival rate Aged Epirubicin Mesna Teniposide Cisplatin Dose-Response Relationship Drug Performance status business.industry Induction chemotherapy Combination chemotherapy Hematology Middle Aged medicine.disease Survival Analysis Chemotherapy regimen Surgery Treatment Outcome Oncology chemistry Vincristine Female business medicine.drug |
| Zdroj: | Annals of Oncology. 12:647-653 |
| ISSN: | 0923-7534 |
| Popis: | Purpose: A prospective randomized trial in small-cell lung cancer (SCLC) was performed to determine if intensification of the platinum dose by giving cisplatin and carboplatin in combination to patients with SCLC yields higher response rates and survival, than carboplatin alone in a combination chemotherapy regimen. Patients and methods: Between September 1992 and October 1997, 280 patients were included in a two armed prospective randomized trial, stratified by stage of disease, LDH and performance status. The treatment was in arm A: three courses induction chemotherapy with carboplatin (AUC = 4, day 1), cisplatin (35 mg/m 2 , days 2 and 3), teniposide (50 mg/m 2 , day 1-5), vincristine (1.3 mg/m 2 , day 1) every four weeks, followed by cyclophosphamide (3 g/m 2 , day X4), 4-epirubicin (4-epidoxorubicin) (150 mg/m 2 , day 112), and finally one course cisplatin, carboplatin, teniposide and vincristine, (days 140 144). Arm B also comprised a total of six courses, identical to those in arm A except for omission of cisplatin. Results: There were no significant differences in the overall treatment outcome for A VS. B, in terms of response rates (72% in both arms), complete response rates (40% and 34%, respectively), or median survival (314 days and 294 days, respectively). However, for patients with limited disease both the CR rate (54% vs. 37%, P < 0.05), overall survival (log-rank test, P < 0.05), and the two-year survival rate (11% VS. 6%, P < 0.05) were higher in the high-dose platinum arm compared to the carboplatin alone arm. Conclusions: The intensification of platinum dose (cisplatin plus carboplatin) in combination chemotherapy significantly increased the complete response rate, overall survival and number of two-year survivors among SCLC patients with limited disease compared to combination therapy with carboplatin alone, suggesting that a more aggressive treatment to this category of patients is worthwhile, while no difference in treatment outcome was observed for patients with extensive disease. |
| Databáze: | OpenAIRE |
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