Summary
Since March 1980, 309 patients with anaplastic small cell carcinoma of the bronchus (ASCB) have received remission induction therapy prior to randomisation to maintenance (M) or no maintenance (NM) chemotherapy. Induction therapy consisted of six courses of vincristine, doxorubicin and cyclophosphamide (VAC) given IV every 3 weeks. Those with limited disease also received mediastinal irradiation. Consenting patients with no unequivocal residual disease were randomised to have no further treatment until relapse or a further eight courses of VAC, at a lower dosage, every 4 weeks. Patients failing to achieve randomisation status received palliative treatment only. The median survival for all patients with limited disease (LD) is 363 days and that for patients with extensive disease (ED) is 272 days (P<0.00001).
Sixty-one patients with ED were randomised. Those having maintenance chemotherapy lived significantly longer (median 372 days) than those who did not continue therapy (median 259 days) (P=0.006). An imbalance in the proportion of ‘complete remitters’ randomised to maintenance therapy does not account for this difference. There is no significant difference between the M and NM groups in the 32 randomised LD patients. Continuing treatment during remission with agents used to induce the remission can prolong survival in patients with extensive stage ASCB.
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References
Aisner J, Whitacre M, Van Echo DA, Wiernik PH (1982) Combination chemotherapy for small cell carcinoma of the lung: continuous versus alternating non-cross resistant combinations. Cancer Treat Rep 66: 221
Brower M, Ihde DC, Johnston-Early A, Bunn PA, Cohen MH, Carney DN, Makuch RW, Matthews MJ, Radice PA, Minna JD (1983) Treatment of extensive stage small cell bronchogenic carcinoma: effect of variation in intensity of induction chemotherapy. Am J Med 75: 993
Cox DR (1972) Regression models and life tables. J Roy Stat, Soc Br 34: 187
Greco FA, Einhorn LH, Richardson RL, Oldham RK (1978) Small cell lung cancer: progress and perspectives. Semin Oncol 5: 323
Hansen HH, Dombernowsky P, Hansen M, Hirsch F (1978): Chemotherapy of advanced small cell anaplastic carcinoma: superiority of a four drug combination to a three-drug combination. Ann Intern Med 89: 177
Johnson RE, Brereton HD, Kent CH (1976) Small cell carcinoma of the lung: attempt to remedy causes of past therapeutic failure. Lancet II: 289
Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observation. Am Stat Assoc J 53: 457
Maurer LH, Tulloh M, Weiss RB, Blom J, Leone L, Glidewell O, Pajak TF (1980) A randomised combined modality trial in small cell carcinoma of the lung. Cancer 45: 30
Peto R, Pike MC, Armitage P, Breslow NE, Cox DR, Howards SV, Mantel N, McPherson K, Peto J, Smith PG (1977) Design and analysis of randomised clinical trials requiring prolonged observation of each patients: II. Analysis and examples. Br J Cancer 35: 1
Woods RL, Levi JA (1983) Chemo/radiotherapy of small cell lunger cancer. J Med Pediatr Oncol 11: 211
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The authors wish to thank Farmitalia Carlo Erba Ltd and Eli Lilly & Co. Ltd for financial support
Midland Small Cell Lung Cancer Group: J. R. M. Bateman, L. A. Birchall, M. F. Bone, P. S. Burge, J. B. Cookson, M. H. Cullen, D. Davies, G. C. Ferguson, J. Fletcher. P. Garner, M. Hemming, L. S. Hill, A. Macfarlane, J. T. Macfarlane, F. J. F. Madden, D. A. L. Morgan, I. C. Paterson, C. Skinner, D. E. Stableforth, J. Stewart, J. M. Wales, P. H. Wright
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Cullen, M., Morgan, D., Gregory, W. et al. Maintenance chemotherapy for anaplastic small cell carcinoma of the bronchus: A randomised, controlled trial. Cancer Chemother. Pharmacol. 17, 157–160 (1986). https://doi.org/10.1007/BF00306746
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DOI: https://doi.org/10.1007/BF00306746