Treatment results of 49 patients (25, limited disease, LD, 24, extensive disease, ED) with small cell lung cancer were retrospectively analyzed. Fifteen patients received chemotherapy with Cyclophosphamide (CPM) and Vincristine (VCR) following thoracic radiotherapy (RT). Twenty-two patients were given induction chemotherapy with CPM, Adriamycin (ADM), and VCR and were followed by thoracic RT. Other chemotherapy consisted of CPM, VCR, Methotrexate, and ADM in 2 patients, 5-FU, CPM, Mitomycin C, and Toyomycin in 1 patient. The remaining 9 patients (2, LD, 7, ED) were treated with RT alone.
The response rate was 80%(64% CR; 16% PR) for LD patients and 33%(4% CR; 29% PR) for ED patients (P<0.001). The three-year survival (Kaplan-Meier's product) of all patients was 14%, with a median survival time (MST) of 8 months. For patients with LD, the 3-year survival was 27%(MST 15 months). Survival of patients with ED was 14% at 1 year, 0% at 2 year (MST 5.5 months). The difference between these figures was statistically significant (P<0.0003). The 3-year survival and relapse-free survival for complete responders with LD were 43%(MST 21 months) and 36%(median CR duration, 11.5 months) respectively. Six of 16 complete responders with LD are alive and well at over 2 years.
Local recurrence rate of the complete responders with LD was 28.8%. None of the 7 complete responders given more than 48 Gy relapsed within the radiation field.
We believe that the addition of thoracic RT to patients with LD is necessary for the control of the primary tumors and for long-term disease-free survival.
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