RESULTS OF THE FIRST HOKKAIDO RANDOMIZED CLINICAL TRIAL FOR SMALL-CELL LUNG CANCER

AN ANALYSIS OF THE PROGNOSTIC FACTOR AND THE PATTERN OF FAILURE IN LIMITED DISEASE

Abstract

This is a report of a joint randomized clinical trial in Hokkaido for Small-Cell Lung Cancer (SCLC) started in November 1985 and closed in November 1988. Theobjective of this first trial was to compare the effects of a three drug regimen (CDDP+VP-16+IFOS) with that of two drugs (CDDP+VP-16), both followed by regional radiotherapy. This study included a total of 92 patients with SCLC. The analysis focused especially on 46 LD patients, to show a prognostic factor and pattern of relapse relative to the field of irradiation. Results were as follows: 1) no significant benefit of survival was obtained by a three drug regimen; 2) the degree of tumor response to initial treatment was the major prognostic factor for both 2-year disease free survival, and local control; 3) chest recurrence, especially “in-field” recurrence was the major cause of failure despite thoracic irradiation of 40-50Gy.