Abstract
Objective
The aim of the study was to compare efficacies and safeties of 2 different treatments of whole brain radiotherapy (WBRT) sequential or concomitant Vm26/DDP for small cell lung cancer (SCLC) patients with brain metastases.
Methods
A total of 39 patients were randomly divided into sequential chemoradiotherapy regime (A group, 20 patients) and concomitant chemoradiotherapy regime (B group, 19 patients). The dose of WBRT was 36 Gy in 18–20 fractions, chemotherapy of Vm26/DDP regimen with teniposide 60 mg/m2 on d1 to d3 and cisplatin 20 mg/m2 on d1 to d5, repeating every 3 weeks. The response was evaluated after WBRT and 2 cycles of chemotherapy.
Results
Total response rates of A and B groups were 70.0% and 78.9% respectively (P = 0.520). The median survival was 11 months in A group and 10 months in B group. Six, twelve and eighteen months cumulative survival rates of A and B groups were 75.0%, 42.5%, 26.2%, and 81.6%, 26.4%, 10.5%, respectively (χ2 = 0.383, P > 0.05). Response rate and the number of brain metastases were independent prognostic factors.
Conclusion
Both sequential and concomitant chemoradiotherapy groups are effective, and the main toxicity with myelosuppression is tolerable after therapy. It can be applied firstly and effectively to the SCLC patients with brain metastases in clinic.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gustafsson BI, Kidd M, Chan A, et al. Bronchopulmonary neuroendocrine tumors. Cancer, 2008, 113: 5–21.
Dearing MP, Steinberg SM, Phelps R, et al. Outcome of patients with small cell lung cancer: effect of changes in staging procedures and imaging technology on prognostic factors over 14 years. J Clin Oncol, 1990, 8: 1042–1049.
Jiang RC, Zhang JN. Advances in the treatment of brain metastases. Chin J Neuro-Oncol (Chinese), 2008, 6: 64–68.
Chen H, Cao XY, Dai SM. Clinical observations on the late-course three dimensional conformal radiation therapy concomitant with hydroxycamptothecin in the treatment of SCLC patients with brain metastases. Shandong Med J (Chinese), 2009, 49: 46–47.
Stewart DJ, Benvenuto JA, Leavens M, et al. Human central nervous system pharmacology of pentamethylmelamine and its metabolites. J Neurooncol, 1983, 1: 357–364.
Chen LK, Liu GZ, Xu GC. Brain irradiation enhances permeability of cis-diamminedichloroplatinum into blood-brain barrier. Chin J Cancer (Chinese), 2001, 20: 291–293.
Donelli MG, Zucchetti M, D’Incalci M. Do anticancer agents reach the tumor target in the human brain? Cancer Chemether Pharmacol, 1992, 30: 251–260.
Zhou JC. Practical intratumoral science. Beijing: People’s Health Publishing House, 2007. 333–335.
Yue X, Zang QC. Sequential treatment of VmP regime and whole brain radiotherapy for small cell lung cancer patients with brain metastases. Chin J Cancer (Chinese), 2004, 23: 1671–1676.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Liu, M., Zhou, Y., Han, Q. et al. Whole brain radiotherapy concomitant or sequential Vm26/DDP in treating small cell lung cancer patients with brain metastases. Chin. -Ger. J. Clin. Oncol. 9, 17–21 (2010). https://doi.org/10.1007/s10330-009-0123-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10330-009-0123-6