Korean J Med.  2006 Apr;70(4):402-409.

A phase II study of etoposide (VP-16), ifosfamide, and carboplatin combination chemotherapy plus concurrent thoracic irradiation for limited stage small cell lung cancer

• Lee Y
• Lee SJ
• Kim YN
• Lee SH
• Kyung SY
• Nam E
• Park SH
• An CH
• Bang SM
• Lee SP
• Park JW
• Lee KC
• Cho EK
• Jeong SH
• Shin DB
• Lee JH

Abstract

BACKGROUND: Small cell lung cancer (SCLC) is very sensitive to both chemotherapy and radiation therapy. In limited disease of SCLC, the addition of radiation therapy to chemotherapy improves survival and decrease local relapse over chemotherapy alone. This study evaluated the response rate, duration of response, overall survival and toxicity for the combination of etoposide, ifosfamide, carboplatin given concurrently with thoracic irradiation in limited SCLC.
METHODS
Twenty eight patients with histologically proven SCLC who have a measurable disease and previously untreated, were enrolled in this study. Each cycle consisted of VP-16 100 mg/m2 IV days 1~3, ifosfamide 1,200 mg/m2 IV days 1~3 with mesna, carboplatin AUC 6 IV day 1. Cycles were repeated every 21days. Patients received a total of median 6,000 cGy thoracic radiation therapy (180~200 cGy/day) starting on the first day of chemotherapy. Prophylactic cranial irradiation was given to complete remission after chemoradiotherapy.
RESULTS
The overall response rate in 27 evaluable patients was 93% (41% of complete response, 52% of partial response). The median time to progression was 10.3 months. The median disease free survival was 18.4 months in patients with complete response. The median overall survival was 16.7 months in all evaluable patients. Hematologic toxicities (> or = Grade3) of 129 cycles of chemotherapy were leukopenia in 38% and fever with infection in 26%. Nonhematologic toxicities (> or = Grade2) of evaluable 27 patients included alopecia in 11%, post-irradiation esophagitis in 44% and pneumonitis in 11%.
CONCLUSIONS
VIC combination chemotherapy with concurrent thoracic irradiation is effective in limited SCLC. It's maior toxicity is myelosuppression.

Keyword

Carboplatin; Chemoradiotherapy Ifosfamide; Etoposide; Small cell lung cancer

MeSH Terms

Alopecia
Area Under Curve
Carboplatin*
Chemoradiotherapy
Cranial Irradiation
Disease-Free Survival
Drug Therapy
Drug Therapy, Combination*
Esophagitis
Etoposide*
Fever
Humans
Ifosfamide*
Leukopenia
Mesna
Pneumonia
Recurrence
Small Cell Lung Carcinoma*
Carboplatin
Etoposide
Ifosfamide
Mesna