Journal of Clinical Oncology, Vol 16, 3323-3328, Copyright © 1998 by American Society of Clinical Oncology

ARTICLES

Abbreviated treatment for elderly, infirm, or noncompliant patients with limited-stage small-cell lung cancer

N Murray, C Grafton, A Shah, K Gelmon, E Kostashuk, E Brown, C Coppin, A Coldman and R Page
Lung Tumor Group, Vancouver Center, British Columbia Cancer Agency, Canada. nmurray@bccancer.bc.ca

PURPOSE: To evaluate the efficacy of an abbreviated treatment plan consisting of two cycles of chemotherapy plus thoracic irradiation in a population of limited-stage small-cell lung cancer (LSCLC) patients who were elderly, infirm, or noncompliant with standard-duration therapy. PATIENTS AND METHODS: Fifty-five LSCLC patients (median age, 73) were treated with one cycle of cyclophosphamide, doxorubicin, and vincristine (CAV) followed 3 weeks later by one cycle of etoposide and cisplatin (EP). Both regimens were administered at conventional full dose. Thoracic irradiation (20 to 30 Gy) was delivered concurrently with EP. RESULTS: Complete response occurred in 28 patients (51%) and partial response in 21 (38%). The median survival time was 54 weeks; the 2-year survival rate was 28% and the actual 5-year survival rate was 18%. Three patients died of toxicity. CONCLUSION: Elderly, infirm, or noncompliant LSCLC patients who are unable to receive standard- duration chemotherapy may have useful palliation and potential for long- term survival with abbreviated chemotherapy (two cycles) and thoracic irradiation.

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