Early crossover of induction chemotherapy in small cell lung carcinoma
Robinson, P.C.; Gill, P.G.; Antic, R.; Drew, M.J.; McLennan, G.
Australian and New Zealand Journal of Medicine 13(1): 21-25
1983
ISSN/ISBN: 0004-8291 PMID: 6309130 Document Number: 204027
A trial was conducted to assess whether early crossover induction chemotherapy would improve the complete response rate in patients with small cell lung carcinoma. Tumor markers were denied in all 48 patients at diagnosis. The patients were reassessed after 3 and 6 cycles of chemotherapy and classified as having complete, partial or no response of tumor on each occasion. Initial induction therapy consisted of cyclophosphamide, vincristine and adriamycin (T1). The therapy of the patients with no tumor response was changed to a regimen (T2) consisting of VP16-213, procarbazine, CCNU and high dose methotrexate with folinic acid rescue. The patients with partial tumor response were randomized to receive T1 or T2, while patients with complete tumor respnse continued with T1. In those patients classified initially as having partial tumor response, crossover chemotherapy did not improve tumor response or survival. Similarly, in patients with no tumor response there was not an acceptable improvement. Non cross resistant crossover chemotherapy using these drug regimens confers no added benefit when compared with continuing the initial therapy.