PATTERNS OF RELAPSE IN PATIENTS WITH SMALL CELL-CARCINOMA OF THE LUNG TREATED WITH ADRIAMYCIN-CYCLOPHOSPHAMIDE CHEMOTHERAPY AND RADIATION-THERAPY

  • 1 January 1979
    • journal article
    • research article
    • Vol. 63  (3) , 359-362
Abstract
Patients (27) with small cell carcinoma of the lung were treated sequentially with induction chemotherapy (adriamycin and cyclophosphamide), radiation therapy (chest and whole-brain), and then maintenance chemotherapy for 2 yr. Twenty responding patients were followed to relapse and patterns of recurrence were observed. This combined treatment resulted in a complete remission rate of 80% and a median survival of 565 days in limited-disease patients. Relapse overwhelmingly occurred in the chest, but patients receiving higher-dose radiation (4000-4500 rads in split-course) had a significant prolongation of time to recurrence compared to patients receiving 3000 rads in a single course of radiation (540 vs. 270 days). Despite a long mean survival, only 1 limited-disease patient relapsed outside of the brain or chest, suggesting that chemotherapy had a good protective effect against micrometastatic disease. Three patients relapsed in the brain at 330, 450 and 520 days, suggesting that in future studies the prophylactic whole-brain radiation (3000 rads) should be intensified.