Alternating cisplatin-etoposide and ifosfamide-vincristine-epirubicin in the management of small cell lung cancer

Abstract

We investigated whether cisplatin and etoposide alternating etoposide ifosfamide-vincristine-epirubucine combination regimen plays a role in thi efficacy and toxicity of patients in small cell lung cancer. From January 1997 to July 1999. We have treated 38 patients with SCLC with 6 courses of alternating chemotherapy consistent of cisplatin 100 mg/m2/IV/day 1+ Etoposide 80 mg/m2 day 1, 3, 5, alternating with Ifosfamide 4 g/m2/IV/day 1+ Vincristine 2 mg/IV/day+Epirubicin 60 mg/m2/IV day 1 in courses 2, 4, 6. Courses were administrated every 3 weeks. After sixth course of chemotherapy the Patients with limited disease (LD) received concominant chest irradiation and in Patients with LD and complete response to treatment. No patient received propylactic cranial irradiation. A total of 38 patients (3 female, 35 male) were included in the study. Their mean age was 59.5 (33-72) years and 18 of them had limited disease, 20 extensive disease (ED). Performance status: Eastern Cooperative Oncology Group (ECOG) 1 in 20 Patients and ECOG 2 18 Patients. Objective response was obtained in 26 (76%) of the patients. Responses were complete in 13 (34%) of them. Six patients remained stable (16%). For Patients with LD the OR rate was % 100 (CR 61%, PR 39%) and Patients with ED: OR: 40% (CR 10%, PR 30%). Median survival was 9 months in LD and 6 months in ED. Relapses after CR occurred in 12 Patients ED (locally; 9 patients, brain 1 patients, liver 1 patients bone) and 1 patient with LD (1 patient brain). Toxicities included grade III-IV 13% leukopenia, 8% grade III-IV nause and vomiting and 39% alopecia. We conclude that the described regimen has high response rate, and well-tolerated, less toxic therapy for small cell lung cancer. Further studies are needed.