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

      Journal of clinical oncology : official journal of the American Society of Clinical Oncology

      administration & dosage, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, therapeutic use, Carcinoma, Small Cell, drug therapy, pathology, radiotherapy, Cisplatin, Combined Modality Therapy, Cyclophosphamide, Doxorubicin, Aged, Etoposide, Female, Humans, Lung Neoplasms, Male, Middle Aged, Survival Rate, Treatment Refusal, Vincristine

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          Abstract

          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. 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. 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. 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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