Does the substitution of cisplatin in a standard four drug regimen improve survival in small cell carcinoma of the lung? A comparison of two chemotherapy regimens

Ninety five patients with small cell carcinoma of the lung were randomly assigned to one of two chemotherapy regimens (VACE or CVACE), each consisting of six cycles at three week intervals. The VACE regimen consisted of six cycles of vincristine 1.2 mg/m2, doxorubicin 40 mg/m2, and cyclophosphamide...

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Bibliographic Details
Published in:Thorax 1991-03, Vol.46 (3), p.172-174
Main Authors: Smith, A P, Anderson, G, Chappell, G, Bowen, D R
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic agents
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Carcinoma, Small Cell - drug therapy
Carcinoma, Small Cell - mortality
Cisplatin - administration & dosage
Cyclophosphamide - administration & dosage
Doxorubicin - administration & dosage
Etoposide - administration & dosage
Female
Humans
Lung Neoplasms - drug therapy
Lung Neoplasms - mortality
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Survival Rate
Vincristine - administration & dosage
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Summary:Ninety five patients with small cell carcinoma of the lung were randomly assigned to one of two chemotherapy regimens (VACE or CVACE), each consisting of six cycles at three week intervals. The VACE regimen consisted of six cycles of vincristine 1.2 mg/m2, doxorubicin 40 mg/m2, and cyclophosphamide 700 mg/m2 on day 1 plus etoposide 110 mg/m2 daily for three days. The CVACE regimen was identical to the VACE regimen for cycles 3 and 4; cycles 1, 2, 4, and 6 consisted of etoposide 110 mg/m2 for three days plus cisplatin 100 mg/m2 with mannitol diuresis on the second day. Forty eight patients received VACE and 47 CVACE. Side effects resulted in withdrawal of four patients receiving VACE and six receiving CVACE. Three deaths were attributed to VACE and one to CVACE. Median survival did not differ between the two treatments overall, though there was a small increase in median survival in partial responders receiving CVACE. It is concluded that replacing four of the six cycles of VACE (vincristine, doxorubicin, cyclophosphamide, and etoposide) with etoposide and cisplatin conferred no overall advantage.
ISSN:0040-6376
1468-3296
DOI:10.1136/thx.46.3.172