The impact of dose intensity of standard chemotherapy regimens in extensive stage small cell lung cancer

R. G. Sheehan, Edward Balaban, E. P. Frenkel

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Oncologists often attenuate the doses of chemotherapy drugs in published standard regimens to avoid toxicity. The impact on survival of this practice in patients with extensive stage small cell lung cancer (SCLC) is uncertain. We have compared the outcome of 85 patients treated with a program of cyclophosphamide, doxorubicin, and vincristine to a group of 37 patients treated with conventional regimens of higher dose intensity. The two groups of patients were shown to be equivalent in terms of staging evaluation, response and survival criteria, and pretreatment prognostic factors. The latter was confirmed by applying a published prognostic algorithm. Complete response rates (38% vs 14%) were significantly better with the higher intensity regimens (p = .003). The median survival (39 vs 26 weeks), 1 year survival (32% vs 12%), and overall survival (p = .002) were superior with the full-dose intensity protocols. Myelotoxicity was also greater with the contemporary treatments. Cox proportional hazards analysis, correcting for pretreatment prognostic variables, confirmed the improved survival with conventional doses of therapy (p = .0055). These results support the concept that full-dose intensity chemotherapy provides survival benefit in patients with extensive stage SCLC.

Original languageEnglish (US)
Pages (from-to)250-255
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume16
Issue number3
DOIs
StatePublished - Jan 1 1993

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Small Cell Lung Carcinoma
Drug Therapy
Survival
Vincristine
Doxorubicin
Cyclophosphamide
Therapeutics
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

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abstract = "Oncologists often attenuate the doses of chemotherapy drugs in published standard regimens to avoid toxicity. The impact on survival of this practice in patients with extensive stage small cell lung cancer (SCLC) is uncertain. We have compared the outcome of 85 patients treated with a program of cyclophosphamide, doxorubicin, and vincristine to a group of 37 patients treated with conventional regimens of higher dose intensity. The two groups of patients were shown to be equivalent in terms of staging evaluation, response and survival criteria, and pretreatment prognostic factors. The latter was confirmed by applying a published prognostic algorithm. Complete response rates (38{\%} vs 14{\%}) were significantly better with the higher intensity regimens (p = .003). The median survival (39 vs 26 weeks), 1 year survival (32{\%} vs 12{\%}), and overall survival (p = .002) were superior with the full-dose intensity protocols. Myelotoxicity was also greater with the contemporary treatments. Cox proportional hazards analysis, correcting for pretreatment prognostic variables, confirmed the improved survival with conventional doses of therapy (p = .0055). These results support the concept that full-dose intensity chemotherapy provides survival benefit in patients with extensive stage SCLC.",
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The impact of dose intensity of standard chemotherapy regimens in extensive stage small cell lung cancer. / Sheehan, R. G.; Balaban, Edward; Frenkel, E. P.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 16, No. 3, 01.01.1993, p. 250-255.

Research output: Contribution to journalArticle

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