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Japanese Journal of Clinical Oncology 30:542-546 (2000)
© 2000 Foundation for Promotion of Cancer Research

A Phase II Study of VP-16–Ifosfamide–Cisplatin Combination Chemotherapy Plus Early Concurrent Thoracic Irradiation for Previously Untreated Limited Small Cell Lung Cancer

In Sook Woo1, Young Suk Park1, Sung Hee Kwon1, Young Iee Park1, Jung Ae Lee1, Myung Jae Park1, In Gyu Hyun1, Ki Suk Jung1, Hoon Sik Bae2, Do Hoon Oh2, Won Seok Kim3, Keunchil Park3, Chan Hyung Park3, Ho Joong Kim3 and Yong Chul Ahn4,+

Departments of 1Internal Medicine and 2Therapeutic Radiology, College of Medicine, Hallym University and Departments of 3Internal Medicine and 4Therapeutic Radiology, College of Medicine, Sungkyunkwan University, Seoul, Korea

Background: At present the addition of thoracic irradiation to combination chemotherapy is a standard treatment for limited staged small cell lung cancer. However, there is still controversy about the optimum timing of chest irradiation. We conducted a phase II study of etoposide (VP-16)–ifosfamide–cisplatin (VIP) combination chemotherapy plus early concurrent thoracic irradiation for the patients with previously untreated limited small cell lung cancer in order to assess if the treatment modality could improve the response rate and the toxicity.

Methods: Forty-four patients with limited small cell lung cancer were treated with etoposide–ifosfamide–cisplatin and concurrent thoracic irradiation. Combination chemotherapy consisted of etoposide 100 mg/m2 (on days 1–3), ifosfamide 1000 mg/m2 (on days 1 and 2) and cisplatin 100 mg/m2 (on day 1). Concurrent thoracic irradiation consisted of a total of 4000 cGy over 4 weeks starting on the first day of the first chemotherapy. All patients who showed a complete response were given prophylactic cranial irradiation for 2.5 weeks.

Results: Forty-four of the 49 patients who entered the study from May 1994 to August 1998 were evaluable. The median age was 59 years and 40 patients had a performance status of 0 or 1. The median survival time was 22.5 months. Twenty-eight patients (62%) showed a complete response and 16 (38%) a partial response. Twenty-four patients (54%) developed grade 3 or 4 neutropenia; there was a 9% RTOG score 3 or 4 esophagitis.

Conclusion: VIP combination chemotherapy and early concurrent thoracic irradiation for patients with limited stage small cell lung cancer revealed excellent antitumor response with tolerable toxicity.

+ For reprints and all correspondence:Young Suk Park, Department of Internal Medicine, Hallym University, KangDong Sacred Heart Hospital, 445, Gil-dong, Kangdong-ku, Seoul, Korea 134-701. E-mail: pys27hmo@yahoo.com


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M. A. Socinski and J. A. Bogart
Limited-Stage Small-Cell Lung Cancer: The Current Status of Combined-Modality Therapy
J. Clin. Oncol., September 10, 2007; 25(26): 4137 - 4145.
[Abstract] [Full Text] [PDF]


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