A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). I: Survival and prognostic factors. Medical Research Council Lung Cancer Working Party.

摘要: A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given 3-week intervals. In two etoposide, cyclophosphamide, methotrexate and vincristine for a either courses (ECMV3) or six (ECMV6). the third regimen, etoposide ifosfamide (E16). Patients limited disease also received radiotherapy primary site after course in all groups. As reported by clinicians, 59% ECMV3, 67% ECMV6 63% EI6 patients experienced moderate severe adverse reactions their chemotherapy. The major symptoms disease, cough, haemoptysis, chest pain, anorexia, dysphagia, palliated more median duration palliation was survival, results being similar Among poor overall condition, physical activity breathlessness on admission, proportions who improved higher group but differences small. groups, levels anxiety fell substantially during treatment. Levels depression lower showed little change. assessed using daily diary card, patterns nausea, vomiting, mood, associated very there less dysphagia better condition between courses, these advantages need be weighed against inconvenience 24-h infusions required, compared 30-min other regimens. companion paper (MRC Lung Cancer Working Party, 1993a) no statistically significant survival advantage any although do not exclude possibility minor six-course conclusion, clinical gain continuing beyond regimen.