Chemotherapy can prolong survival in patients with advanced non-small-cell lung cancer--report of a Canadian multicenter randomized trial.

摘要: The survival benefit of combination chemotherapy to patients with advanced non-small-cell carcinoma the lung (NSCLC) is controversial. To study this question, National Cancer Institute Canada (NCIC) Clinical Trials Group conducted a prospective randomized trial comparing best supportive care (BSC) two regimens, vindesine and cisplatin (VP), cyclophosphamide, doxorubicin, (CAP). Between February 1983 January 1986, 23 centers across entered 251 on study. Eighteen participated in three-arm schema (150 patients); choosing not participate no-chemotherapy arm followed two-arm VP CAP (101 additional patients). Altogether, 233 were eligible. Patients had measurable or evaluable disease, either distant metastases (82.5%) bulky limited disease considered inoperable unsuitable for radical radiotherapy. treatment groups comparable terms age, sex, performance status, histology, extent, weight loss. overall response rates (complete [CR] plus partial [PR]) arms CAP, 15.3%, VP, 25.3% (P = .06). portion median 32.6 weeks when treated 24.7 17 BSC. significance differences survival, adjusted prognostic factors, as follows: v BSC, P .02; .01; .05. Toxicity was significant, leukopenia severe greater degree occurring 37.8% (CAP) 40.0% vomiting 12.2% 23.3% neurotoxicity 15.6% (VP).