Cyclic-alternating versus response-oriented chemotherapy in small-cell lung cancer: a German multicenter randomized trial of 321 patients.

摘要: To test whether alternating chemotherapy is a favorable treatment modality in small-cell lung cancer (SCLC), 334 patients were randomized to receive either fixed cyclic-alternating with ifosfamide/etoposide (IE), cyclophosphamide, doxorubicin, and vincristine (CAV), or response-oriented IE therapy up maximal response subsequently an immediate switch CAV. In both arms, six cycles given 3-week intervals. After chemotherapy, limited-stage disease received chest irradiation 45 Gy. Prophylactic cranial 30 Gy was applied all complete responders. No maintenance response. Minimum follow-up 2 years. Of 321 assessable patients, the overall rate 70% for cyclic 77% treatment. Complete remission (CR) rates 26% versus 26%. The median survival times 9.7 months 10.7 treatment; 2-year 11% 9%. (LD) there of 12.5 12.3 21% 18%. extensive-stage (ED) 8.5 9.1 months, 3% 4%. From these results, we conclude that according hypothesis Goldie et al has no advantage comparison sequential strategy second-line protocol at time further first-line seen. Our major aim SCLC administer active regimen any during course regardless used.