A randomized combined modality trial in small cell carcinoma of the lung comparison of combination chemotherapy‐radiation therapy versus cyclophosphamide‐radiation therapy effects of maintenance chemotherapy and prophylactic whole brain irradiation

摘要: A randomized trial of combined modality therapy employing combination chemotherapy (cyclophosphamide (CTX) and methotrexate (MTX), CTX, MTX Vincristine (VCR) VCR high-dose with citrovorum rescue) radiation was compared to cyclophosphamide in 258 patients pulmonary small cell carcinoma. Patients were also randomized: 1) determine the effects prophylactic whole brain irradiation; 2) establish maintenance chemotherapy. Survival, frequency response site relapse different limited disease (LD) (disease confined lung, mediastinum supraclavicular lymph nodes) when spread beyond these sites (extensive disease) (ED). No survival advantage seen LD employed, although complete remission greater three drugs than one or two (48% vs. 32%). In ED for (60% 40%), but there no advantage. The median time responders similar extensive (12.1 months), 23.8% alive at 24 months none ED. Maintenance significantly prolonged by 16.8 33% 9% who unmaintained. Prophylactic irradiation prevented metastases only 4% developing this complication as 18% control subjects, did not influence survival.