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Cisplatin plus etoposide with and without ifosfamide in extensive small-cell lung cancer: a Hoosier Oncology Group study.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 1995 Oct; Vol. 13 (10), pp. 2594-9. - Publication Year :
- 1995
-
Abstract
- Purpose: To determine whether the addition of ifosfamide to cisplatin plus etoposide improves the response rate, time to disease progression, or overall survival in previously untreated patients with extensive-stage small-cell carcinoma of the lung (SCLC).<br />Patients and Methods: Patients with extensive SCLC with a Karnofsky performance score (KPS) > or = 50 and adequate renal function and bone marrow reserve were eligible. Patients with CNS metastases were eligible and received concurrent whole-brain radiotherapy. Patients were randomized to receive cisplatin (20 mg/m2) plus etoposide (100 mg/m2) (VP) both given intravenously (i.v.) on days 1 to 4 or cisplatin (20 mg/m2), ifosfamide (1.2 g/m2), and etoposide (75 mg/m2) (VIP) all given i.v. on days 1 to 4. Cycles were repeated every 3 weeks for four cycles.<br />Results: From May 1989 through March 1993, 171 patients were randomized (84 to VP and 87 to VIP). The median follow-up duration is 26 months. All patients were assessable for survival; 163 were fully assessable for response and 162 for toxicity. Myelosuppression was greater with VIP. Objective responses were observed in 55 of 82 (67%) and 59 of 81 (73%) assessable patients treated with VP and VIP, respectively (difference not significant). The difference in the median time to progression was statistically different (P = .039). The median survival times on VP and VIP were 7.3 months and 9.0 months, respectively (P = .045 for survival curves by stratified log-rank test) with 2-year survival rates of 5% versus 13%, respectively.<br />Conclusion: VIP combination chemotherapy is associated with an improved time to progression and overall survival over VP therapy in patients with extensive SCLC.
- Subjects :
- Adult
Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Brain Neoplasms diagnostic imaging
Brain Neoplasms secondary
Carcinoma, Small Cell mortality
Carcinoma, Small Cell radiotherapy
Carcinoma, Small Cell secondary
Cisplatin administration & dosage
Combined Modality Therapy
Cranial Irradiation
Disease-Free Survival
Etoposide administration & dosage
Female
Follow-Up Studies
Humans
Ifosfamide administration & dosage
Injections, Intravenous
Lung Neoplasms mortality
Lung Neoplasms radiotherapy
Male
Middle Aged
Proportional Hazards Models
Radiography
Regression Analysis
Survival Rate
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Small Cell drug therapy
Lung Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 13
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 7595712
- Full Text :
- https://doi.org/10.1200/JCO.1995.13.10.2594