Yonsei Med J.  1989 Mar;30(1):30-37. 10.3349/ymj.1989.30.1.30.

Phase II study of cyclophosphamide, doxorubicin, and vincristine (CAV) and etoposide plus cisplatin (EP) alternating chemotherapy combined with radiotherapy in small cell lung cancer

• Park YJ
• Koh EH
• Kim J
• Roh JK
• Chang J
• Ahn CM
• Sohn HY
• Kim SK
• Lee WY
• Kim K
• Suh CO
• Kim GE
• Loh JJ
• Kim BS

• KMID: 1118127
• DOI: http://doi.org/10.3349/ymj.1989.30.1.30

Abstract

The development of drug resistance is the major limiting factor influencing the survival of patients with small cell lung cancer (SCLC). We have thus examined the activity of cyclophosphamide, doxorubicin and vincristine (CAV) alternating with etoposide and cisplatin (EP) in 35 patients with SCLC. The treatment courses were alternated every 3 or 4 weeks. After induction chemotherapy, patients with limited disease (LD) received thoracic radiotherapy (5000 cGy), prophylactic cranial irradiation (3000 cGy) and maintenance chemotherapy and patients with extensive disease (ED) received maintenance chemotherapy only. In this group of 35 patients, 13 had limited disease (LD) and 22 had extensive disease (ED). After completion of the therapy, 100% of the patients with LD achieved complete plus partial remission (CR + PR) and 68% of the patients with ED achieved CR + PR. The median survival time was 66 weeks (15.3 months) in patients with LD and 44 weeks (10.2 months) in patients with ED. The over all survival for patients with LD was superior to that for patients with ED (p less than 0.05). Also, median response duration for patients with LD (35 wks) was longer than that for patients with ED (17 weeks) (p less than 0.05). The primary site was the most vulnerable site to relapse (18 patients). Toxicity was mild to moderate and acceptable, and there were no treatment-related deaths. These results suggest that the alternation of CAV and EP is effective treatment strategy in the management of SCLC. A randomized controlled study will be required to discriminate the actual effect of this alternating regimen.

Keyword

Alternating chemotherapy; small cell lulng cancer; limited disease; extensive disease

MeSH Terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Carcinoma, Small Cell/drug therapy/*radiotherapy
Cisplatin/*therapeutic use
Combined Modality Therapy
Cyclophosphamide/therapeutic use
Doxorubicin/therapeutic use
Drug Evaluation
Female
Human
Lung Neoplasms/drug therapy/*radiotherapy
Male
Middle Age
Vincristine/therapeutic use