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Japanese Journal of Clinical Oncology 16:271-277 (1986)
© 1986 Foundation for Promotion of Cancer Research

research-article

Randomized Trial Comparing Chemotherapy Alone and Chemotherapy Plus Chest Irradiation in Limited Stage Small Cell Lung Cancer: A Preliminary Report

TAISUKE OHNOSHI, M.D., SHUNKICHI HIRAKI, M.D., SHIN KAWAHARA, M.D., HIDETOSHI YAMASHITA, M.D., TOSHIRO YONEI, M.D., JUN-ICHI ISHII, M.D., TOMOO EGAWA, M.D., AKIRA KOZUKA, M.D., YOSHIO HIRAKI, M.D.* and IKURO KIMURA, M.D.

Department of Medicine, Okayarna University Medical School Okayama
1Department of Radiology, Okayarna University Medical School Okayama

Reprint requests: Taisuke Ohnoshi M.D., Department of Medicine, Okayama University Medical School, 2-5-1, Kadamachi-Oka-yama 700, Japan.

Received July 8, 1986; In order to assess the effectiveness of chest irradiation in addition to intensive chemotherapy in limited stage small cell lung cancer, 50 patients were randomized to receive either chemotherapy alone or chemotherapy plus chest irradiation, between April 1981 and October 1985. The chemotherapy regimen consisted of a four-drug combination of cyclophosphamide, vincristine, methotrexate, and procarbazine, and a three-drug combination of etoposide, adriamycin, and nimustine, given alternately every 8 weeks. One group of 26 patients received the chemotherapy alone, and another group of 24 patients received chest irradiation with 40 Gy between cycles 1 and 2 of the chemotherapy. Complete response rates were quite similar in the two groups; 50% for those receiving chemotherapy alone, and 59% for those receiving chemotherapy plus chest irradiation. There were no significant differences in median survival (15 months versus 12 months) and in long-term survival rates between the two groups with a median follow-up period of 26 months. The combined modality treat ment was more toxic than chemotherapy aIone two patients receiving such treatment died of radiation pneumonitis. It is concluded that chest irradiation combined with chemotherapy does not affect the response rate, survival, or pattern of recurrence in patients with limited stage small cell lung cancer.


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