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The combined modality approach in the treatment of inoperable small-cell anaplastic carcinoma of the lung

Integration von Chemotherapie und Strahlentherapie in der Behandlung des kleinzelligen Bronchialcarcinoms

Zeitschrift für Krebsforschung und Klinische Onkologie volume 89, pages 9–18 (1977)Cite this article

Summary

The combined modality approach with combination chemotherapy (“COMB” or “BACO”) and radiotherapy was used in a pilot study comprising 35 evaluable patients with inoperable small-cell anaplastic carcinoma of the lung. Treatment strategy was based on prior assessment of prognostic factors such as histology, performance status and extent of disease. Median survival time was 39.8 weeks for “COMB” treated patients and 21.2 weeks for “BACO” treated patients. Although the combined modality approach has been very helpful against a variety of human cancers it should be used with caution since not all combination chemotherapy regimens are compatible with radiotherapy. Mechanisms of interactions between cytostatic agents and X-rays are discussed with regard to enhanced tumor cell kill and possible toxic side effects.

Zusammenfassung

Von 35 auswertbaren Patienten mit histologisch gesichertem kleinzelligen, inoperablen Bronchialcarcinom wurden 9 zunächst nach dem „BACO“ und 26 nach dem „COMB“ Polychemotherapieschema behandelt. Darauf schloß sich eine Radiotherapie der primär befallenen Herde an, wobei eine Herddosis von 3000 rad erreicht wurde (3000/15/21). Das „BACO“-Schema eignet sich nach unseren Ergebnissen und Befunden anderer Untersuchter schlechter für eine Kombination mit Strahlentherapie (Mittlere Überlebenszeit MÜZ=21,2 Wochen), während für „COMB“ und Strahlentherapie eine MÜZ von 39,8 Wochen erreicht werden konnte. Bei der Integration von Chemotherapie und Strahlentherapie muß daher neben einer verbesserten Abtötung von Tumorzellen die Gefahr toxischer Nebenwirkungen berücksichtigt werden. Für jedes Polychemotherapieschema sollte die Möglichkeit der Kombination mit der Radiotherapie gesondert überprüft werden. Zur Zeit scheint die planmäßige Integration von Radio- und Chemotherapie die aussichtsreichste Behandlung des inoperablen kleinzelligen Bronchialcarcinoms darzustellen.

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Affiliations

  1. Innere Universitätsklinik und Poliklinik (Tumorforschung) und Strahlenklinik, Klinikum der Gesamthochschule Essen, Hufelandstraße 55, D-4300, Essen 1, Federal Republic of Germany

    R. Osieka, C. G. Schmidt, H. -B. Makoski & E. Scherer

  2. Department of Medical Oncology and Department of Radiology, University of Essen, Federal Republic of Germany

    R. Osieka, C. G. Schmidt, H. -B. Makoski & E. Scherer

Authors
  1. R. Osieka
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  2. C. G. Schmidt
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  3. H. -B. Makoski
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  4. E. Scherer
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Supported by the Landesamt für Forschung, Ministerium für Wissenschaft und Forschung des Landes NRW, Düsseldorf

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Osieka, R., Schmidt, C.G., Makoski, H.B. et al. The combined modality approach in the treatment of inoperable small-cell anaplastic carcinoma of the lung. Z. Krebsforsch. 89, 9–18 (1977). https://doi.org/10.1007/BF02571684

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  • DOI: https://doi.org/10.1007/BF02571684

Keywords

  • Bleomycin
  • Median Survival Time
  • Adriamycin
  • BACO
  • Bronchogenic Carcinoma