Moderate dose-escalation of combination chemotherapy with concomitant thoracic radiotherapy in limited-disease small-cell lung cancer: prolonged intrathoracic tumor control and high central nervous system relapse rate. Groupe d'Oncologie-Pneumologie Clinique de l'Université Catholique de Louvain, Brussels and Liège, Belgium.

van de Velde, H;Bosquée, L;Weynants, P.;Canon, J L;Humblet, Yves;et.al.
(1999) Annals of Oncology — Vol. 10, n° 9, p. 1051-1057 (1999)

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  • van de Velde, H
    Author
  • Bosquée, L
    Author
  • Weynants, P.
    Author
  • Canon, J L
    Author
  • Rosier, Jean-ClaudeUCLouvain
    Author
  • Humblet, YvesUCLouvain
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Abstract
BACKGROUND: The role of chemotherapy dose-intensification in small-cell lung cancer (SCLC) remains unclear. This phase I-II study evaluates feasibility and outcome of combination chemotherapy at moderately elevated doses with concomitant thoracic radiotherapy in limited-disease SCLC. PATIENTS AND METHODS: Moderately elevated doses of ifosfamide-epirubicin (cycles 1 and 3) and of carboplatin-etoposide (cycles 2 and 4) were given with G-CSF and peripheral blood stem-cell (PBSC) support. Thoracic radiotherapy (40 Gy) was given once daily during the first five days of each cycle. RESULTS: Overall toxicity was acceptable; most common side-effects were myelosuppression and asthenia. All 35 eligible patients responded (23 CR, 12 PR). Median time to progression was 15 months: median overall survival was 24.6 months. Only 6 of 25 relapsing patients (24%) presented with a locoregional recurrence while 12 of 25 (48%) relapsed in the central nervous system (CNS). CONCLUSIONS: This regimen is a feasible dose-intensification with an acceptable toxicity profile. Its efficacy was demonstrated by a 100% response rate, an excellent local tumor control rate and a median survival of 24.6 months. In the absence of PCI, CNS relapse is a major problem if adequate local control is achieved.
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van de Velde, H., Bosquée, L., Weynants, P., Canon, J. L., Rosier, J.-C., & Humblet, Y. (1999). Moderate dose-escalation of combination chemotherapy with concomitant thoracic radiotherapy in limited-disease small-cell lung cancer: prolonged intrathoracic tumor control and high central nervous system relapse rate. Groupe d’Oncologie-Pneumologie Clinique de l’Université Catholique de Louvain, Brussels and Liège, Belgium. Annals of Oncology, 10(9), 1051-1057. https://doi.org/10.1023/A:1008306732232 (Original work published 1999)