Sequentielle Induktionschemotherapie und Strahlenbehandlung inoperabler kleinzelliger Bronchialkarzinome

摘要: To study the potential benefit of sequential chemotherapy in inoperable small cell lung cancer (SCLC), from 1982 to 1986 ninety-one patients with histologically proven and previously untreated SCLC (median age: 53 years; median Karnofsky status: 80%) were randomly assigned an initial therapy adriamycin (since 1984 epirubicin), cyclophosphamide, vincristine (ACO resp. EPICO) or etoposide/cisplatin (VP16/DDP). Treatment courses repeated every 3 weeks for a total ≤6 crossover after maximum cycles either regimen. Limited disease (LD) bronchoscopical, computertomographical (re-) mediastinoscopical complete remission (CR) received thoracic irradiation 40 Gy observation only. Overall, 60 out 85 evaluable achieved objective remission. A CR was observed 24/51 (47%) limited disease, 8/34 (24%) extensive disease. Both, ACO (EPICO) VP16/DDP equally effective as second-line therapy. Moreover, failure could be 13% following alternative second line combination. In 28% LD otherwise residual tumor detected by mediastinoscopy. Median survival times 14 (CR: 16) months 10 15) ED patients. At present, is significantly improved irradiated versus non-irradiated (25 vs. 13 months, p<0.04). The rates this are comparable those historical control group treated plus radiotherapy alone.