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1. Hu Y, Cui Y, Wang M, Cui S, Wang R, Gao Y, Yang Y: [Long-term results of chemotherapy alone or combined with radiation therapy for limited-stage small cell lung cancer]. Zhongguo Fei Ai Za Zhi; 2003 Jun 20;6(3):201-3

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Long-term results of chemotherapy alone or combined with radiation therapy for limited-stage small cell lung cancer].
  • BACKGROUND: To evaluate therapeutic outcome of limited stage small cell lung cancer treated with chemotherapy alone or combined with radiation therapy with different doses.
  • METHODS: A retrospective analysis was performed in 128 limited-stage small cell lung cancer patients who were treated with three different ways of treatment, from February 1988 to March 1998 in Heilongjiang Cancer Hospital.
  • Forty-two patients received chemotherapy alone (C), 48 patients were treated by interdigitating chemoradiotherapy (IDG) and other 38 patients received concurrent chemoradiotherapy (CON).
  • For thoracic radiation, 20 patients received a dose of ≤45 Gy, 23 ≥60 Gy, and 43 > 45 Gy but < 60 Gy .
  • RESULTS: The 3-year survival rates were 23.7%, 20.8% and 4.8% in the CON, the IDG and the C groups respectively.
  • There was a significant difference between the CON and the C groups ( P < 0.05), as well as between the IDG and the C groups ( P < 0.05).
  • Loco-regional recurrence rate was significantly higher in ≤45 Gy group (55.0%) than that in ≥60 Gy group (8.7%)( P < 0.01).
  • CONCLUSIONS: The chemotherapy combined radiotherapy may improve the survival of patients with limited-stage small cell lung cancer.

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  • (PMID = 21266120.001).
  • [ISSN] 1009-3419
  • [Journal-full-title] Zhongguo fei ai za zhi = Chinese journal of lung cancer
  • [ISO-abbreviation] Zhongguo Fei Ai Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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2. Huncharek M, McGarry R: A meta-analysis of the timing of chest irradiation in the combined modality treatment of limited-stage small cell lung cancer. Oncologist; 2004;9(6):665-72
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  • [Title] A meta-analysis of the timing of chest irradiation in the combined modality treatment of limited-stage small cell lung cancer.
  • The objective of this study was to determine whether initial combined chemoradiation results in superior 1-, 2-, and 3-year survivals in the treatment of limited-stage small cell lung cancer versus sequential or split-course therapy.
  • Pooling data from eight randomized controlled trials enrolling over 1,500 patients showed that early integration of chest radiotherapy with systemic chemotherapy increases overall survival by 34%-216%, depending on the end point of interest.
  • Etoposide (E) plus cisplatin (P) in conjunction with chest irradiation appears to offer the greatest increase in survival versus delayed or split-course radiation therapy and non-EP-containing drug schedules.
  • The available randomized trial data support early concurrent chest radiotherapy and systemic chemotherapy in the form of E and P in the management of limited-stage small cell lung cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / mortality. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / mortality. Lung Neoplasms / therapy
  • [MeSH-minor] Humans. Radiotherapy Dosage. Radiotherapy, Adjuvant / methods. Randomized Controlled Trials as Topic. Time Factors

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  • (PMID = 15561810.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 33
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3. Chen G, Wang L, Jiang G, Qian H, Fu X, Zhao S, Ding L: [Chemotherapy combined with chest radiation therapy in the treatment of 95 patients with limited stage small cell lung cancer]. Zhongguo Fei Ai Za Zhi; 2000 Oct 20;3(5):340-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Chemotherapy combined with chest radiation therapy in the treatment of 95 patients with limited stage small cell lung cancer].
  • BACKGROUND: To analyse retrospectively the results and prognostic factors of 95 patients with limited stage small cell lung cancer treated with chemotherapy plus chest radiation therapy.
  • METHODS: Ninety-five patients with limited stage small cell lung cancer were treated with combination chemotherapy plus chest radiation therapy from December,1989 to June,1997.There were 84 males and 11 females with median age of 58 years (32-75 years).The P-TNM stages of the disease were as follows:stage I disease,3 patients; stage II disease,7 patients; stage IIIA disease,49 patients and stage IIIB disease,36 patients.Chemotherapy regimens were CAP (cyclophosphamide,doxorubicin,cisplatin),EP(etoposide,cisplatin),TP(Teniposide,cisplatin),or IEP (ifosphamide,etoposide,cisplatin).Median cycles were 6 (1-10).After one cycle of chemotherapy,patients received chest radiation therapy with median total tumor dose of 59.1Gy(43.8-76.9Gy)/31fx(22-64fx) for 48 days(30-73days).The radiation fields covered tumors with 1.5-2.0cm margins.Supraclavicular region and brain did not receive prophylactic irradiation.
  • RESULTS: Of the ninety-five patients,55(58%) had a complete response,36(38%) had a partial response,three had a stable disease and one had a disease progression.The median survival time was 28 months.The 1-,2-,3- and 5-year survival rates were 85%,62%,31% and 13%,respectively.The 1-,2-,3-,and 5-year local control rates were 95%,86%,77% and 64%,respectively.The 1-,2-,3- and 5-year distant metastasis rates were 23%,52%,73%,and 83%,respectively.From multivariate regression analyses,KPS≥70 and complete response and partial response could be the favorable predictors.
  • CONCLUSIONS: Chemotherapy combined with chest irradiation in limited stage small cell lung cancer can get better survival and local control and less distant metastases.KPS≥70 and complete response and partial response might be the favorable predictors.

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  • (PMID = 20979717.001).
  • [ISSN] 1009-3419
  • [Journal-full-title] Zhongguo fei ai za zhi = Chinese journal of lung cancer
  • [ISO-abbreviation] Zhongguo Fei Ai Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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4. Miller AA, Wang XF, Bogart JA, Hodgson LD, Rocha Lima CM, Radford JE, Vokes EE, Green MR, Cancer and Leukemia Group B (CALGB): Phase II trial of paclitaxel-topotecan-etoposide followed by consolidation chemoradiotherapy for limited-stage small cell lung cancer: CALGB 30002. J Thorac Oncol; 2007 Jul;2(7):645-51
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  • [Title] Phase II trial of paclitaxel-topotecan-etoposide followed by consolidation chemoradiotherapy for limited-stage small cell lung cancer: CALGB 30002.
  • PURPOSE: We sought to evaluate the activity and tolerance of the rationally designed sequence of paclitaxel-topotecan-etoposide, a nonplatinum regimen, as induction therapy for limited-stage small-cell lung cancer before combined chemo- and radiotherapy.
  • PATIENTS AND METHODS: Patients with measurable disease, performance status 0 to 2, no prior therapy, and adequate organ function were eligible.
  • Paclitaxel (110 mg/m2, administered intravenously on day 1), topotecan (1.5 mg/m2, administered orally on days 2 to 4), and etoposide (160 mg/m2, administered orally on days 5 to 7 every 21 days), with filgrastim for two cycles, were followed by chest irradiation to 70 Gy (to postinduction tumor volume) concurrent with carboplatin (area under the curve of 5, administered intravenously on day 1) and etoposide (100 mg/m2 on days 1 to 3 every 21 days) without filgrastim for three cycles (five chemotherapy cycles total).
  • We aimed to determine the response rates to induction and overall therapy, overall and failure-free survival, and toxicity.
  • The primary statistical endpoint was to differentiate between complete response rates of 50 and 70% for the overall treatment program.
  • RESULTS: Between June 2001 and January 2003, 65 patients were enrolled, but one never started therapy, and one was ineligible.
  • Induction chemotherapy resulted in six (10%) complete responses and 35 (56%) partial responses.
  • Frequent (>20%) grade 3/4 toxicities during all therapy included neutropenia, febrile neutropenia, anemia, thrombocytopenia, fatigue, and dysphagia.
  • CONCLUSIONS: This treatment regimen has significant activity in limited-stage small-cell lung cancer but did not meet our prospectively defined criteria for further investigation in this setting.
  • The addition of etoposide and the use of a sequenced administration schedule did not seem to improve overall activity beyond our prior experience with a topotecan-paclitaxel doublet.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Etoposide / administration & dosage. Female. Follow-Up Studies. Humans. Male. Middle Aged. Paclitaxel / administration & dosage. Retrospective Studies. Severity of Illness Index. Survival Rate. Topotecan / administration & dosage. Treatment Outcome

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  • (PMID = 17607121.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA31946; United States / NCI NIH HHS / CA / CA33601
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 7M7YKX2N15 / Topotecan; P88XT4IS4D / Paclitaxel
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5. Bogart JA, Watson D, McClay EF, Evans L, Herndon JE, Laurie F, Seagren SL, Fitzgerald TJ, Vokes E, Green MR: Interruptions of once-daily thoracic radiotherapy do not correlate with outcomes in limited stage small cell lung cancer: analysis of CALGB phase III trial 9235. Lung Cancer; 2008 Oct;62(1):92-8
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  • [Title] Interruptions of once-daily thoracic radiotherapy do not correlate with outcomes in limited stage small cell lung cancer: analysis of CALGB phase III trial 9235.
  • PURPOSE: Retrospective data suggests prolonging the time to complete thoracic radiotherapy (TRT) may negatively impact tumor control and survival in limited stage small cell lung cancer (LSCLC).
  • TRT, to a planned dose of 50Gy in 2Gy daily fractions, was initiated with the fourth chemotherapy cycle.
  • TRT interruptions were mandated for hematologic toxicity (granulocytes<1000/mm3 or platelets<75,000/mm3) and esophageal toxicity (dysphagia necessitating intravenous hydration).
  • RESULTS: TRT interruptions > or =3 days occurred in 115 patients (43%), most frequently during the 4th week of TRT, and did not differ between treatment arms.
  • Variables including advanced age (>70 years), gender, race, or radiotherapy treatment volume did not predict for TRT interruptions.
  • CONCLUSION: Toxicity mandated interruptions of conventional dose, once-daily, TRT may not adversely affect outcomes for patients receiving TRT concurrent with chemotherapy (cycle 4) for LSCLC.

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  • (PMID = 18367288.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / U10 CA032291; United States / NCI NIH HHS / CA / CA33601; United States / NCI NIH HHS / CA / CA04457; United States / NCI NIH HHS / CA / CA11789; United States / NCI NIH HHS / CA / U10 CA077658; United States / NCI NIH HHS / CA / CA02599; United States / NCI NIH HHS / CA / CA77406; United States / NCI NIH HHS / CA / CA47555; United States / NCI NIH HHS / CA / CA32291; United States / NCI NIH HHS / CA / CA41287; United States / NCI NIH HHS / CA / U10 CA045808; United States / NCI NIH HHS / CA / CA03927; United States / NCI NIH HHS / CA / U10 CA031946; United States / NCI NIH HHS / CA / U10 CA033601; United States / NCI NIH HHS / CA / U10 CA045389; United States / NCI NIH HHS / CA / CA60138; United States / NCI NIH HHS / CA / CA26806; United States / NCI NIH HHS / CA / CA45389; United States / NCI NIH HHS / CA / CA45808; United States / NCI NIH HHS / CA / CA12046; United States / NCI NIH HHS / CA / U10 CA077440; United States / NCI NIH HHS / CA / CA16450; United States / NCI NIH HHS / CA / CA77440; United States / NCI NIH HHS / CA / CA11028; United States / NCI NIH HHS / CA / U10 CA041287; United States / NCI NIH HHS / CA / U10 CA047559; United States / NCI NIH HHS / CA / CA04326; United States / NCI NIH HHS / CA / CA08025; United States / NCI NIH HHS / CA / CA74811; United States / NCI NIH HHS / CA / CA47559; United States / NCI NIH HHS / CA / U10 CA074811; United States / NCI NIH HHS / CA / CA77658; United States / NCI NIH HHS / CA / CA12449; United States / NCI NIH HHS / CA / CA37135; United States / NCI NIH HHS / CA / CA77298; United States / NCI NIH HHS / CA / CA31983; United States / NCI NIH HHS / CA / CA31946; United States / NCI NIH HHS / CA / U10 CA003927; United States / NCI NIH HHS / CA / CA07968; United States / NCI NIH HHS / CA / CA47545
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 094ZI81Y45 / Tamoxifen
  • [Other-IDs] NLM/ NIHMS76269; NLM/ PMC4465446
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6. Chen J, Jiang R, Garces YI, Jatoi A, Stoddard SM, Sun Z, Marks RS, Liu Y, Yang P: Prognostic factors for limited-stage small cell lung cancer: a study of 284 patients. Lung Cancer; 2010 Feb;67(2):221-6
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  • [Title] Prognostic factors for limited-stage small cell lung cancer: a study of 284 patients.
  • Combined modality therapy is the standard care for limited stage-small cell lung cancer (LS-SCLC) and has led to a significant improvement in patients' survival.
  • This study sought to investigate and define the importance of prognostic effects of known and controversial factors especially the impact of smoking status and treatment strategies.
  • A total of 284 patients with LS-SCLC were diagnosed and prospectively followed from 1997 to 2008 at Mayo Clinic; their characteristics and survival outcome were assessed on the basis of age, gender, smoking history, performance status (PS), tumor recurrence or progression, and treatment using Cox proportional hazards models.
  • (1) Although neither smoking status (former or current smokers) nor intensity (pack-years smoked) at the time of SCLC diagnosis were significant survival predictors, compared to continued smokers (who never quit smoking), patients who quit at or after diagnosis cut the risk of death by 45% (HR=0.55, 95% CI 0.38-0.79); patients who quit before lung cancer diagnosis also experienced survival benefit (HR=0.72, 95% CI 0.52-1.00). (2) Thoracic radiotherapy and platinum-based chemotherapy could significantly improve survival but the timing (within or after one month of diagnosis) of starting chemotherapy or radiation therapy did not. (3) After adjusting for other known factors, a lower PS did not predict poorer survival, suggesting that PS should not be the only factor for making treatment decisions.
  • In conclusion, this study demonstrated the negative impact of continued cigarette smoking on survival; therefore, clinicians and all care providers should strongly encourage smoking cessation at diagnosis of LS-SCLC.

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  • [Copyright] Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
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  • (PMID = 19497635.001).
  • [ISSN] 1872-8332
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] ENG
  • [Grant] United States / PHS HHS / / 115857; United States / NCI NIH HHS / CA / R01 CA115857; United States / NCI NIH HHS / CA / R01 CA084354-08; United States / PHS HHS / / 84354; United States / NCI NIH HHS / CA / R01 CA084354; United States / NCI NIH HHS / CA / R01 CA 80127; United States / NCI NIH HHS / CA / R01 CA080127-09; United States / NCI NIH HHS / CA / R01 CA080127; United States / NCI NIH HHS / CA / CA115857-04; United States / NCI NIH HHS / CA / R01 CA115857-04; United States / NCI NIH HHS / CA / CA084354-08
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Other-IDs] NLM/ NIHMS114302; NLM/ PMC2815153
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7. Zhao H, Gu J, Hua F, Xu H, Li L, Yang B, Han Y, Liu S, Hong S: [A meta-analysis of the timing of chest radiotherapy in patients with limited-stage small cell lung cancer]. Zhongguo Fei Ai Za Zhi; 2010 Sep;13(9):892-7
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  • [Title] [A meta-analysis of the timing of chest radiotherapy in patients with limited-stage small cell lung cancer].
  • The aim of this study is to explore whether the timing of chest radiation may influence the survival of the patients with limited-stage small-cell lung cancer (LSSCLC) by performing a literature-based meta-analysis.
  • METHODS: By searching Medline, CENTRAL (the Cochrane central register of controlled trials), CBM, and CNKI, et al, we collected both domestic and overseas published documents about randomized trials comparing different timing chest radiotherapy in patients with LS-SCLC.
  • Early chest radiation was regarded as beginning within 30 days after the start of chemotherapy.
  • The combined odds ratio (OR) and the 95% confidence interval (CI) were calculated to estimate the mortality in 2 or 3 years and toxicity of the two treatments.
  • CONCLUSIONS: No statistical difference was observed in 2/3 years survival and toxicity, including pneumonitis, esophagitis and thrombocytopenia, between early radiation and late radiotherapy in LS-SCLC.
  • [MeSH-major] Lung Neoplasms / radiotherapy. Small Cell Lung Carcinoma / radiotherapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Lung / pathology. Lung / radiation effects. Male. Middle Aged. Randomized Controlled Trials as Topic. Time Factors. Treatment Outcome

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  • (PMID = 20840819.001).
  • [ISSN] 1999-6187
  • [Journal-full-title] Zhongguo fei ai za zhi = Chinese journal of lung cancer
  • [ISO-abbreviation] Zhongguo Fei Ai Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't
  • [Publication-country] China
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8. Georgoulias V, Scagliotti G, Miller V, Eckardt J, Douillard JY, Manegold C: Challenging the platinum combinations: Docetaxel (Taxotere) combined with gemcitabine or vinorelbine in non-small cell lung cancer. Semin Oncol; 2001 Feb;28 Suppl 2:15-21

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Challenging the platinum combinations: Docetaxel (Taxotere) combined with gemcitabine or vinorelbine in non-small cell lung cancer.
  • The limited single-agent activity of cisplatin, its toxicity profile, and the inconvenience involved in hydrating patients has compelled researchers to investigate other treatments as possible alternative therapies in non-small cell lung cancer.
  • Phase II studies show that the combination of docetaxel (Taxotere; Aventis, Antony, France) and gemcitabine is active in stage IIIB/IV non-small cell lung cancer not previously treated by chemotherapy.
  • Response rates of up to 54% and a median survival time of 13 months have been reported.
  • The combination of docetaxel plus vinorelbine is also active in non-small cell lung cancer and preliminary data suggest that this schedule with prophylactic filgrastim may optimize tolerability and dose intensity.
  • Docetaxel combined with other new agents, particularly gemcitabine, may offer another useful alternative to cisplatin-based chemotherapy in patients with good performance status.

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  • (PMID = 28140077.001).
  • [ISSN] 1532-8708
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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9. Murray N, Sheehan F: Limited stage small cell lung cancer. Curr Treat Options Oncol; 2001 Feb;2(1):63-70
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  • [Title] Limited stage small cell lung cancer.
  • The management of limited stage small cell lung cancer begins with a firm pathologic diagnosis and careful staging.
  • Patients with adequate pulmonary function, ambulatory performance status, and no evidence of metastatic disease outside a "tolerable" local radiotherapy volume should have consultation from both medical and radiation oncology disciplines for planning of integrated therapy.
  • The chemotherapy prescription recommended is cisplatin plus etoposide at standard doses for four chemotherapy cycles.
  • Patients with complete response and excellent partial response should receive prophylactic cranial irradiation after completion of all chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Cisplatin / administration & dosage. Combined Modality Therapy / economics. Cost-Benefit Analysis. Cranial Irradiation. Etoposide / administration & dosage. Humans. Neoplasm Staging

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  • (PMID = 12057141.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 19
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10. Sueyama H: [Limited stage small cell lung cancer]. Nihon Igaku Hoshasen Gakkai Zasshi; 2002 Apr;62(5):194-7
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  • [Title] [Limited stage small cell lung cancer].
  • Recent progress in the treatment of limited stage small cell lung cancer (LD-SCLC) is reviewed.
  • SCLC represents 15-20% of all lung cancers.
  • Combination chemotherapy is considered the treatment of choice because SCLC usually is widespread at diagnosis.
  • The PE (CDDP + Etoposide) regimen and concurrent thoracic irradiation have yielded the best survival results in LD-SCLC.
  • Although the timing of chemotherapy and thoracic radiation is still controversial, the early integration of chemotherapy and thoracic irradiation produces a small survival advantage over the late integration of chemoradiotherapy.
  • Meta-analysis has shown that prophylactic cranial irradiation reduced the rate of brain metastases and increased 3-year survival by 5% in patients with SCLC in complete response.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Evidence-Based Medicine. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Meta-Analysis as Topic

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  • (PMID = 12043222.001).
  • [ISSN] 0048-0428
  • [Journal-full-title] Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica
  • [ISO-abbreviation] Nihon Igaku Hoshasen Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 22
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11. Akyurek S, Onal C, Cagar A, Hicsonmez A, Andrieu MN, Kurtman C: Mid-course thoracic radiotherapy with cisplatin-etoposide chemotherapy in limited-stage small-cell lung cancer. Med Oncol; 2006;23(4):499-505
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mid-course thoracic radiotherapy with cisplatin-etoposide chemotherapy in limited-stage small-cell lung cancer.
  • Combination chemoradiotherapy is a standard treatment for limited-stage small-cell lung cancer (LSSCLC).
  • In this study, the outcome of 70 patients who had received TRT at a dose of median 50 Gy (range, 46-60 Gy) with a second or third cycle of chemotherapy (CHT) either concurrently (n=41) or sequentially (n=29) were analyzed retrospectively.
  • The 2-yr local control, disease-free survival, and overall survival rates were 60%, 19%, and 36%, respectively.
  • Grade 3-4 hematologic toxicity, on the other hand, appeared significantly more in the concurrent arm (p < 0.001).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / therapeutic use. Combined Modality Therapy. Dose Fractionation. Etoposide / therapeutic use. Female. Humans. Male. Middle Aged. Radiotherapy. Retrospective Studies. Survival Analysis. Survival Rate

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  • (PMID = 17303908.001).
  • [ISSN] 1357-0560
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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12. Arvidson NB, Khuntia D, Tomé WA: Dose escalation model for limited-stage small-cell lung cancer. Radiother Oncol; 2009 Jun;91(3):379-85
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  • [Title] Dose escalation model for limited-stage small-cell lung cancer.
  • BACKGROUND AND PURPOSE: To construct a model for the local dose-response relationship of limited-stage small-cell lung cancer (LS-SCLC) along with subsequent models for dose-per-fraction escalation.
  • MATERIALS AND METHODS: Reported doses and 2-year progression free survival (PFS(2year)) rates from LS-SCLC studies were used to construct a dose-response model.
  • Modeling incorporated effects of chemotherapy, incomplete repair of sublethal damage and variations in both kick-off time for rapid reproliferation and effective tumor cell doubling time.
  • Response was modeled as a function of overall treatment duration in order to shed light on the optimum radiotherapy treatment duration.
  • RESULTS: Modeling response as a function of treatment duration resulted in an optimum treatment duration of 3 weeks for both fractionation schedules.
  • CONCLUSIONS: This modeling suggests more aggressive treatment through escalation of dose-per-fraction, which may result in substantial gains in local PFS(2year).
  • This points towards treatment durations of 3 weeks as being optimal with a BID schedule predicting possible gains in local PFS(2year) at lower rates of expected late complications than a QD schedule.
  • [MeSH-major] Lung Neoplasms / radiotherapy. Models, Statistical. Radiotherapy Dosage. Small Cell Lung Carcinoma / radiotherapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Disease Progression. Dose Fractionation. Dose-Response Relationship, Radiation. Humans. Neoplasm Staging. Treatment Outcome

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  • (PMID = 19187993.001).
  • [ISSN] 1879-0887
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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13. Qiao TK, Zhou DA, Xin L, Shu L, Wu W: [Concurrent radiotherapy combined with carboplatin and etoposide in limited stage small cell lung cancer]. Zhonghua Jie He He Hu Xi Za Zhi; 2004 Apr;27(4):237-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Concurrent radiotherapy combined with carboplatin and etoposide in limited stage small cell lung cancer].
  • OBJECTIVE: To observe the effect of concurrent radiotherapy combined with carboplatin and etoposide in limited stage small cell lung cancer.
  • METHODS: Ninety patients with limited stage small cell lung cancer were randomized into two groups, concurrent treatment group (group A) and sequential treatment group (group B).
  • All the patients in two groups received radiotherapy (60 Gy in 6 weeks) and six courses of chemotherapy (carboplatin and etoposide).
  • Radiotherapy was started in the first course of chemotherapy in group A.
  • Patients of group B were treated by radiation between the fourth and the fifth course of chemotherapy.
  • RESULTS: The median survival time was 26 months in group A and 19 months in group B.
  • The differences of two groups were significant (P < 0.05).
  • CONCLUSION: Concurrent radiotherapy combined with carboplatin and etoposide can significantly improve median survival time and 5-year survival rate of patients with limited stage small cell lung cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Radiotherapy, High-Energy
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Combined Modality Therapy / methods. Etoposide / administration & dosage. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Survival Rate

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  • (PMID = 15144613.001).
  • [ISSN] 1001-0939
  • [Journal-full-title] Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
  • [ISO-abbreviation] Zhonghua Jie He He Hu Xi Za Zhi
  • [Language] chi
  • [Publication-type] Clinical Trial; Comparative Study; English Abstract; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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14. Miller KL, Marks LB, Sibley GS, Clough RW, Garst JL, Crawford J, Shafman TD: Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys; 2003 Jun 1;56(2):355-9
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  • [Title] Routine use of approximately 60 Gy once-daily thoracic irradiation for patients with limited-stage small-cell lung cancer.
  • PURPOSE: To review the outcome of patients with limited-stage small-cell lung cancer receiving daily thoracic irradiation (RT) to approximately 60 Gy.
  • METHODS AND MATERIALS: The records of patients treated with RT for limited-stage small-cell lung cancer between 1991 and 1999 at Duke University were retrospectively reviewed.
  • Sixty-five patients were identified who had received continuous course once-daily 1.8-2 Gy fractions to approximately 60 Gy (range 58-66).
  • All patients received chemotherapy (CHT); 32 received concurrent RT/CHT and 33 sequential CHT and then RT.
  • The time from diagnosis to local failure, tumor progression, and death was assessed using actuarial methods.
  • One case of acute Grade 3 esophagitis developed.
  • Six were mild and resolved with treatment.
  • CONCLUSION: CHT plus approximately 60 Gy of once-daily RT for limited-stage small-cell lung cancer was generally well tolerated.
  • The survival rates were less than have been reported using 45 Gy in 1.5-Gy twice-daily fractions (2-year overall survival rate 47% compared with 30% in this study), but may be comparable because fewer than one-half our patients received concurrent CHT/RT and only 26% received prophylactic cranial RT.
  • The relatively low rate of normal tissue morbidity in our patients supports the use of conventional once-daily fractionation to > or = 60 Gy.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cranial Irradiation. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy / adverse effects. Radiotherapy Dosage. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 12738309.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Pijls-Johannesma MC, De Ruysscher D, Lambin P, Rutten I, Vansteenkiste JF: Early versus late chest radiotherapy for limited stage small cell lung cancer. Cochrane Database Syst Rev; 2005;(1):CD004700
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Early versus late chest radiotherapy for limited stage small cell lung cancer.
  • BACKGROUND: It is standard clinical practice to combine chemotherapy and chest radiotherapy in treating patients with limited-stage small cell lung cancer.
  • OBJECTIVES: To establish the most effective way of combining chest radiotherapy with chemotherapy for patients with limited-stage small cell lung cancer in order to improve long-term survival.
  • SELECTION CRITERIA: Randomised controlled clinical trials comparing different timing of chest radiotherapy in patients with limited-stage small cell lung cancer.
  • There were differences in the timing and the overall treatment time of chest radiotherapy, the overall treatment time of , and the type of chemotherapy used.
  • MAIN RESULTS: No significant differences in the 2-year and the 5-year survival were found, whether chest radiotherapy was delivered within 30 days after the start of chemotherapy or later.
  • When the only study that delivered chest radiotherapy during cycles of non-platinum chemotherapy was excluded, a trend for the 5-year survival was observed (RR:0.93, p=0.07) in favour of early radiation, but not for the 2-year survival.
  • Survival at 5 years, but not at 2 years, was significantly better for those having early chest radiotherapy delivered in an overall treatment time of less than 30 days compared with a longer treatment time (RR: 0.90, p=0.006).
  • However, a trend for a higher chance to develop pneumonitis when early chest radiotherapy was delivered during non-platinum based chemotherapy was observed.
  • The optimal integration of chemotherapy and chest radiotherapy in patients with limited-stage small cell lung cancer is unknown.
  • Therefore, further research is needed to establish the most effective combination of radiotherapy and chemotherapy in this disease.
  • [MeSH-major] Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Radiotherapy / methods. Randomized Controlled Trials as Topic. Time Factors

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  • (PMID = 15674960.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] England
  • [Number-of-references] 25
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16. Laurie SA, Logan D, Markman BR, Mackay JA, Evans WK, Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care: Practice guideline for the role of combination chemotherapy in the initial management of limited-stage small-cell lung cancer. Lung Cancer; 2004 Feb;43(2):223-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Practice guideline for the role of combination chemotherapy in the initial management of limited-stage small-cell lung cancer.
  • An evidence-based practice guideline was developed to identify the optimal combination chemotherapy regimen, schedule of administration, and duration of therapy for the first-line treatment of adults with limited-stage small-cell lung cancer.
  • If bolus etoposide-cisplatin is the treatment of choice, evidence from one randomized trial suggests that the optimal sequence of administration is cisplatin followed by etoposide.
  • The use of maintenance chemotherapy is not indicated.
  • There is insufficient evidence to support the routine use of dose-intensive regimens outside a clinical trial, to determine the optimal duration of chemotherapy, or to support the routine substitution of carboplatin for cisplatin in combination chemotherapy regimens in this patient population.
  • RECOMMENDATIONS: Etoposide-cisplatin is the preferred chemotherapy regimen for patients with limited-stage small-cell lung cancer when concurrent thoracic radiotherapy is used.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Combined Modality Therapy. Dose-Response Relationship, Drug. Drug Administration Schedule. Evidence-Based Medicine. Humans. Prognosis. Randomized Controlled Trials as Topic. Survival Analysis

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  • (PMID = 14739044.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Guideline; Journal Article; Meta-Analysis; Practice Guideline; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
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17. Genestreti G, Tassinari D, Pasquini E, Papi M, Roudnas B, Fochessati F, Fantini M, Poggi B, Agostini V, Ravaioli A: Outcomes of small cell lung cancer (SCLC) chemotherapy. Results of a retrospective analysis. J Clin Oncol; 2004 Jul 15;22(14_suppl):7277

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcomes of small cell lung cancer (SCLC) chemotherapy. Results of a retrospective analysis.
  • First line chemo-radiotherapy is the treatment of choice in SCLC, while second line treatment at relapse still remains controversial.
  • METHODS: The records of all the patients with SCLC we treated from 1990 to 2003 were reviewed.
  • Overall survival was the main outcome of our review; survival analysis was performed using the Cox regression model, stratifying the patients on the basis of the stage of the disease (limited vs extended).
  • First line treatment was cyclophosphamide-epidoxorubicin-etoposide (CEVP16) before 1999, and carboplatin-etoposide (CP) from 1999 till today.
  • The kind of first line treatment (334 days vs 238 days for CEVP16 and CP respectively, p=0.01), the use of complementary radiotherapy (390 days vs 208 days respectively, p=0.009) and the second line chemotherapy at relapse (430 days vs 212 days respectively, p=0.001) were independent prognostic factors of survival.
  • CONCLUSIONS: Although our data are extracted by a retrospective analysis, it is of interest the datum of a better outcome of patients treated with CEVP16 when compared with the outcome of those treated with CP.
  • On the opposite, a selection bias could influenced the better outcome of patients treated with II line chemotherapy at relapse for the exclusion from the treatment of patients with low performance status (supported by IOR).

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  • (PMID = 28013599.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Belvedere O, Follador A, Rossetto C, Sibau AM, Defferrari C, Aita M, Meduri S, Fasola G, Ceschia T, Grossi F: Final report of a randomized phase II study of docetaxel/oxaliplatin (DO) and docetaxel (D) in previously treated non-small cell lung cancer (NSCLC) patients (pts). A novel design, Alpe-Adria Thoracic Oncology Multidisciplinary group study (ATOM 019). J Clin Oncol; 2009 May 20;27(15_suppl):e19010

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Final report of a randomized phase II study of docetaxel/oxaliplatin (DO) and docetaxel (D) in previously treated non-small cell lung cancer (NSCLC) patients (pts). A novel design, Alpe-Adria Thoracic Oncology Multidisciplinary group study (ATOM 019).
  • : e19010 Background: No combination regimen has proven superior to single agent chemotherapy as 2nd-line treatment for NSCLC.
  • The absence of cross-resistance with cisplatin/carboplatin, favorable toxicity profile, along with both pre-clinical and clinical evidence of activity make O a good candidate for combination with D as 2nd-line therapy of NSCLC.
  • METHODS: This multicenter, non-comparative randomized phase II trial evaluated the activity of D (75 mg/m2 d1) and O (70 mg/m2 d2) every 3 weeks in previously treated NSCLC pts; the comparator arm was D (75 mg/m2 d1 every 3 weeks).
  • This one-stage, three-outcome phase II trial design (Sargent, Control Clin Trials 2001) had 21 evaluable pts/arm.
  • All had histologically confirmed NSCLC that progressed during/after platinum-based chemotherapy.
  • Primary endpoint was response rate; secondary endpoints were toxicity, time to progression (TTP), 1-yr survival.
  • With 48 pts evaluable, partial response was seen in 20% and 8% of pts; stable disease in 52% and 32% and progressive disease in 24% and 56% for DO and D, respectively; 1 pt was inevaluable due to early death (D arm).
  • CONCLUSIONS: This study shows how novel phase II trial designs enrolling a limited number of pts may help identify promising regimens for subsequent study in phase III trials.
  • The level of activity for DO we observed satisfied the pre-defined study primary endpoint and warrants further evaluation of this combination as 2nd-line therapy for NSCLC.
  • Protocol developed at the 6<sup>th</sup> FECS/AACR/ASCO Workshop on Methods in Clinical Cancer Research, Flims 2004, with Professors Marc Buyse and Chris Twelves.

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  • (PMID = 27962629.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Gianni L, Genestreti G, Tassinari D, Papi M, Imola M, Rudnas B, Monticelli G, Oliverio G, Pasquini E, Ravaioli A: Relationship between hemoglobin (Hb) level drop and outcome of patients (pts) treated for small cell lung cancer (SCLC): Our retrospective analysis. J Clin Oncol; 2004 Jul 15;22(14_suppl):7271

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Relationship between hemoglobin (Hb) level drop and outcome of patients (pts) treated for small cell lung cancer (SCLC): Our retrospective analysis.
  • : 7271 Background: Anemia during chemo-radiotherapy negatively impacts treatment outcomes in a variety of tumor types.
  • There is only one retrospective study that evaluate the relationship between Hb level and the outcome of pts treated with chemo-radiotherapy for SCLC (Jeyabalan et al: Proc ASCO 2003).
  • METHODS: A retrospective analysis of pts treated for SCLC between 1990 to 2003 was performed.
  • We collected information about stage disease, chemo-radiotherapy performed, level of Hb at the start (Hbt0) and after three months (Hbt3) of treatment.
  • Median age was 63 years (range 44-81) with 44 (42.3%) limited disease, 59 (56.7%) extended disease and 1 (1%) missing.
  • First-line chemotherapy was Cyclophosphamide/Epirubicin/Etoposide (CEVP-16) in 74 (71.2%) pts or Cisplatin/Etoposide (CVP-16) in 30 (28.8%) pts.
  • At 3 months all pts performed at least 3 chemotherapy cycles (range 3-4).
  • The Hbt0 was 13.35 gr/dl± 0.17 (media± ES) and the Hbt3 was 10.63 gr/dl± 0.16 (media± ES) with a difference of 2.7 gr/dl (IC95%=2.28-3.15).
  • The Hb drop in CEVP-16 arm was 2.97± 0.28 gr/dl and 2.09± 0.39 in CVP-16 arm, with a p=0.068 at the Student t-test.
  • We recorded 16 (15.4%) complete response, 47 (45.2%) partial response, 12 (11.5%) stable disease, 22 (21.2%) progression disease and 7 (6.7%) response not evaluated.
  • 53 (51.1%) pts performed second-line chemotherapy.
  • At today, 99 (95.2%) pts are died with a median survival of 348 days (Kaplan-Meyer analysis).
  • Prospective trials may offer insights on the relationship between anemia, chemo-radiotherapy and outcome of SCLC pts.

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  • (PMID = 28013601.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Batus M, Myint R, Coon J, Basu S, Kaiser K, Fidler M, Bonomi P: N-cadherin, E-cadherin, ERCC1, and c-kit expression in small cell lung cancer (SCLC) and potential for new therapeutic targets. J Clin Oncol; 2009 May 20;27(15_suppl):e22157

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] N-cadherin, E-cadherin, ERCC1, and c-kit expression in small cell lung cancer (SCLC) and potential for new therapeutic targets.
  • : e22157 Background: Minimal advances have been made in the treatment of SCLC.
  • Molecular markers may allow us to better stratify patients (pts) for new treatment options and drug combinations.
  • The objective of our study was to determine the frequency and potential prognostic significance of N-cadherin (N-cad), E-cadherin (E-cad), ERCC1, and c-kit (CD117) expression in SCLC.
  • METHODS: Tissue from 132 pts with SCLC was retrospectively stained for N-cad, E-cad, ERCC1, and c-kit.
  • Frequency of expression (% of tumor cells staining positive) was measured on a scale of 0-4 (freq 0=no expression (<1%), freq 1=1-10%, freq 2=11-35%, freq 3=36-70%, freq 4=71-100%).
  • Charts were reviewed for stage, performance status, date of diagnosis/death, survival, and treatment (type, dates, response).
  • RESULTS: Age range 42 to 97 years, 65 male:67 female, and 64 had limited and 68 had extensive stage.
  • However, tumors that expressed c-kit with frequency ≥ 3 had a trend toward superior survival compared with frequency < 3.
  • Median survival for c-kit frequency ≥ 3 was 496 days compared to 312 days for frequency < 3 (p = 0.09, Log-Rank Test).
  • CONCLUSIONS: In our retrospective study of 132 SCLC pts, we found that all 4 markers were expressed in greater than 50% of specimens, and that higher c-kit expression was associated with marginally significant increase in overall survival.
  • Though previous experience with imatinib alone or with chemotherapy showed limited clinical activity in unselected SCLC pts, given preclinical synergy with cisplatin, it seems reasonable to consider combination therapy with cisplatin/etoposide and imatinib in pts selected for high c-kit expression.

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  • (PMID = 27963548.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Hamada C, Ohta M, Wada H, Fujimura S, Kodama K, Imaizumi M, Nakanishi Y, Matsuoka N: Survival benefit of oral UFT for adjuvant chemotherapy after completely resected non-small-cell lung cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):7002

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Survival benefit of oral UFT for adjuvant chemotherapy after completely resected non-small-cell lung cancer.
  • : 7002 Background: Survival rate should be used as the primary endpoint in clinical trials assessing the response of non-small-cell lung cancer to postoperative adjuvant chemotherapy.
  • Single studies usually do not provide clear-cut conclusions because of limited sample size.
  • We therefore performed a meta-analysis of all properly randomized clinical trials comparing long-term adjuvant chemotherapy with UFT, an oral fluorinated pyrimidine, to surgery alone in patients with completely resected non-small-cell lung cancer, and a number of subgroup analyses and tests for interaction were performed to evaluate generalizability of drug effect.
  • RESULTS: The results of meta-analysis demonstrated that adjuvant chemotherapy with UFT significantly improved overall survival (5-year OS, HR, 0.77; 95%CI, 0.63-0.94; p=0.011, 7-year OS, HR, 0.74; 95%CI, 0.61-0.88; p=0.001).
  • CONCLUSIONS: We conclude that postoperative adjuvant chemotherapy with UFT has a beneficial effect uniformly in patients with completely resected early-stage non-small-cell lung cancer.

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  • (PMID = 28016295.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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22. Ready N, Herndon J, Vokes E, Bogart J, Crawford J, Dipetrillo T, Green M: Initial cohort toxicity evaluation for chemoradiotherapy (CRT) and ZD1839 in stage III non-small cell lung cancer (NSCLC): A CALGB stratified phase II trial. J Clin Oncol; 2004 Jul 15;22(14_suppl):7078

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Initial cohort toxicity evaluation for chemoradiotherapy (CRT) and ZD1839 in stage III non-small cell lung cancer (NSCLC): A CALGB stratified phase II trial.
  • : 7078 Background: ZD1839 (Iressa) is a small molecule inhibitor of the EGFR that has single agent activity in advanced NSCLC and preclinical evidence of being a radiosenitizer.
  • METHODS: Patients with stage III NSCLC were assigned to stratum 1 (PS 0-1>5% weight loss or PS 2) or stratum 2 (PS 0-1weight loss < 5%).
  • Patients on both strata received induction paclitaxel (P) 200 mg/m<sup>2</sup> and carboplatin (C) AUC of 6 IV every three weeks for 2 cycles as well as ZD1839 250 mg PO/day.
  • Stratum 2 received the same RT with concurrent ZD1839 250 mg/day, and P 50 mg/m<sup>2</sup> plus C AUC of 2 weekly for 7 doses.
  • There was a 2-week break from ZD1839 after RT finished to assess recovery from treatment.
  • Maintenance ZD1839 was started if all toxicities were grade < 2.
  • Initial enrollment was limited to 6 institutions and conference calls were held every 2 weeks.
  • RESULTS: Toxicity and safety of therapy was evaluated for ZD1839 concurrent with RT or CRT, since the safety of ZD1839 as a single agent or with doublet chemotherapy has been demonstrated.
  • In the initial cohort of 6 patients in stratum 2, all treatment related toxicities improved to grade ≤ 2 by 4 weeks after the completion of RT.

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  • (PMID = 28016139.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Gaspar LE, Gay GE, Crawford J, Putnam JB, Herbst RS, Bonner JA: Limited small cell lung cancer (stages I-III): Observations from the National Cancer Database. J Clin Oncol; 2004 Jul 15;22(14_suppl):7042

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Limited small cell lung cancer (stages I-III): Observations from the National Cancer Database.
  • : 7042 Background: The standard treatment of limited stage small cell lung cancer (LSCLC) has changed over the past 15 years.
  • Standard treatment for LSCLC currently involves multiple agent chemotherapy and early concurrent thoracic radiation therapy.
  • METHODS: Four patient cohorts, diagnosed with limited small cell lung cancer (LSCLC) in 1985, 1990, 1995 and 2000 were studied to describe demographic and treatment pattern changes as well as survival rates across cohorts (total patients 22,969).
  • The proportion of patients aged ≥ 70 yrs also significantly increased over time, 31.6% in 1985 to 44.9% in 2000.
  • Over these years the utilization of chemoradiation as the primary treatment of LSCLC increased from 34.6% to 51.9% of patients (from 37.0% to 60.5% for patients < 70 yrs, from 29.5% to 41.3% for patients ≥ 70 yrs) During the same time the use of chemotherapy as the sole treatment declined from 30.7 % in 1985 to 21.7% in 2000.
  • Chemotherapy as the sole treatment was utilized in 25.9% of the 70 yrs and older population in 2000, as compared to 18.3% in those younger than 70 yrs.
  • The percent of patients for which there was no treatment given did not change significantly over the cohorts (14.3% in 1985, 13.7% in 2000).
  • The 5-yr survival and confidence interval (CI) for the 1985, 1990 and 1995 cohort treated with chemoradiation are as follows: 10.5% (CI 6.75-14.25), 11.88% (CI 9.63-14.13), 13.3% (11.2-15.4%) Conclusions: Despite changes in demographics and treatment during these time intervals the 5-yr survival for patients treated with chemoradiation did not increase significantly as shown in the table below.
  • These results demonstrate the continued need for the evaluation of new treatments in this group of patients.

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  • (PMID = 28016064.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Asmis TR, Reaume MN, Dahrouge S, Malone S: Genitourinary (GU) small cell carcinoma (SCC): A retrospective review of treatment and survival patterns at the Ottawa Regional Cancer Center (ORCC). J Clin Oncol; 2004 Jul 15;22(14_suppl):4545

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Genitourinary (GU) small cell carcinoma (SCC): A retrospective review of treatment and survival patterns at the Ottawa Regional Cancer Center (ORCC).
  • : 4545 Background: SCC of the bladder (SCCB), prostate (SCCP), and kidney (SCCK) remains a therapeutic challenge.
  • Much debate exists in the literature about the ideal course of therapy.
  • METHODS: All charts of all patients seen at the ORCC between 1991-2002 for any GU diagnosis were manually reviewed to identify GUSCC.
  • Demographic, staging, treatment and outcome data was extracted.
  • The Veterans Administration small cell lung cancer classification of limited and extensive disease was adapted to the genitourinary system(limited:disease localized to the true and false pelvis, extensive:disease beyond the pelvis).
  • RESULTS: 555, 858 and 5066 new cases of primary renal, bladder and prostate cancer respectively, were identified.
  • 8/12 SCCB had limited disease.
  • 5 patients with SCCB are alive and were all limited at diagnosis.
  • Surviving patients received similar therapy with transurethral resection of the bladder tumor, platinum chemotherapy, etoposide (4-6 cycles), and radical radiotherapy (56-60 Gray).
  • 2/10 had limited stage.
  • Of these two patients one was treated with platinum chemotherapy and etoposide followed by radical radiotherapy (66 Gray), the other patient had a poor performance status at diagnosis and was treated with palliative hormonal ablation and radiotherapy.
  • Our table illustrates the median survival according to site and stage (SCCB and SCCP combined) at diagnosis.
  • CONCLUSIONS: Our findings support that GU SCC is an aggressive cancer.
  • We have found that limited stage SCCB and SCCP, when treated with platinum/etoposide chemotherapy along with radical radiotherapy tends to have a more favourable outcome than that of extensive GUSCC.

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  • (PMID = 28016041.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Brenner B, Shia J, Klimstra DS, Gonen M, Shah MA, Leonard GD, Kelsen DP: High-grade neuroendocrine carcinomas of the gastrointestinal tract: The Memorial Sloan - Kettering Cancer Center experience of 143 cases. J Clin Oncol; 2004 Jul 15;22(14_suppl):4123

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High-grade neuroendocrine carcinomas of the gastrointestinal tract: The Memorial Sloan - Kettering Cancer Center experience of 143 cases.
  • : 4123 Background: High grade neuroendocrine carcinoma (HGNEC) of the gastrointestinal tract (GIT) is a very rare and aggressive malignancy.
  • METHODS: The records of all patients with histologically proven HGNEC of the GIT seen at Memorial Sloan Kettering Cancer Center between 1980 and 2003 were reviewed.
  • RESULTS: One-hundred forty-three patients were identified, 73 with small cell carcinoma (SmCC) and 70 with large cell neuroendocrine carcinoma (LCNEC).
  • Thirty-eight percent of tumors had non-HGNEC components and 46% presented with extensive disease (ED), according to the VALSG staging system used in pulmonary SmCC.
  • In limited disease (LD), surgery and chemoradiation resulted in a small group of long-term survivors, while chemotherapy was essentially palliative.
  • Using chemotherapy, most commonly platinum and etoposide, a 50% response rate was observed.
  • Performance status (p<0.01) and weight loss (p=0.01) were found to predict outcome.
  • Tumors from different locations shared most of their clinicopathological features, although those arising at the upper GIT were found at an earlier stage and tended to have better prognosis.
  • Mixed tumor histology is common and may affect therapy.
  • Response rate to chemotherapy appears lower than expected from the perceived similarity to SmCC of the lung.

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  • (PMID = 28014517.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Ferrer N, Cobo M, Paredes A, Méndez M, Muñoz-Langa J, Rueda A, Álvarez de Mon M, Sánchez-Hernández A, Gallego R, Torrego J: Phase II study of bevacizumab in combination with cisplatin and docetaxel as first-line treatment of patients (p) with metastatic non-squamous non-small cell lung cancer (NSCLC). J Clin Oncol; 2009 May 20;27(15_suppl):e19023

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II study of bevacizumab in combination with cisplatin and docetaxel as first-line treatment of patients (p) with metastatic non-squamous non-small cell lung cancer (NSCLC).
  • : e19023 Background: Bevacizumab (B), in addition to platinum-based chemotherapy, is indicated for 1st-line treatment of p with advanced NSCLC other than predominantly squamous cell histology.
  • However, there are limited data on the safety and efficacy of B in combination with other widely used chemotherapy doublets for NSCLC.
  • This is a single-arm, open- labeled, single-stage phase II trial of cisplatin (C), docetaxel (D) and B for NSCLC.
  • METHODS: Eligibility criteria: chemo- naïve, stage IIIB wet or IV, non-squamous NSCLC, PS 0-1, no brain metastases and no history of gross hemoptysis.
  • P received D (75 mg/m<sup>2</sup>), C (75 mg/m<sup>2</sup>), and B (15 mg/kg iv) on day 1 every 3 weeks for up to 6 cycles, followed by B 15 mg/kg alone every 3 weeks until disease progression or toxicity.
  • RESULTS: 50 p were enrolled (enrollment completed): 24% female, median age 60 (36-74), PS 1: 64%, adenocarcinoma: 72%; stage IV: 92%.
  • Two p did not start treatment.
  • 56% completed 6 cycles of treatment; 24% received ≥ 12 cycles of B.
  • Of interest, 41.5% developed grade <3 epistaxis and 17% hypertension (1 p grade 3).
  • 18 of 48 p have experienced progression or death with a median SLP of 7.8 months (95% CI: 6.6-NR).
  • CONCLUSIONS: Treatment with C, D and B, followed by maintenance B in 1<sup>st</sup> line of advanced non-squamous NSCLC shows an acceptable toxicity profile and promising efficacy.

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  • (PMID = 27962586.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Gandhi L, Chu QS, Stephenson J, Johnson BE, Govindan R, Bonomi P, Eaton K, Fritsch H, Munzert G, Socinski M: An open label phase II trial of the Plk1 inhibitor BI 2536, in patients with sensitive relapse small cell lung cancer (SCLC). J Clin Oncol; 2009 May 20;27(15_suppl):8108

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An open label phase II trial of the Plk1 inhibitor BI 2536, in patients with sensitive relapse small cell lung cancer (SCLC).
  • We investigated the antitumor efficacy, safety and PK of BI 2536 in patients (pts) with sensitive relapse SCLC.
  • METHODS: This open label single arm phase II study followed a Gehan two-stage design.
  • Primary objective was to determine the antitumor efficacy of BI 2536 in SCLC pts with disease recurrence ≥60 days after completion of first-line chemotherapy.
  • 18 pts had to complete 2 courses to be evaluable for stage 1 analysis.
  • In case of ≥2 partial or complete antitumor responses (RECIST criteria), stage 2 accrual would continue until 40 pts were entered.
  • Patients received 200 mg BI 2536 as a 1h i.v. infusion on Day 1 every 3 weeks.
  • Dose escalation to 250 mg (cycle 3 onwards) was encouraged in pts with <Grade 2 drug related non-hematologic and <Grade 3 hematologic toxicity.
  • RESULTS: 23 pts (14 female, 9 male, 21 extensive disease, 2 limited disease), median age 60 yrs (range: 35-77) were treated.
  • All patients had disease recurrence >60 days after completion of first-line therapy.
  • Of 23 pts, no objective antitumor responses were observed, 7 had stable disease as best response, 14 had progression, 2 were not evaluable.
  • Due to the lack of antitumor responses, trial accrual was terminated after stage 1.
  • Drug related grade 3/4 AEs were neutropenia (13%/26%), grade 3/4 thrombocytopenia (1 pt each), grade 3/4 anemia (1 pt each), grade 4 sepsis (1 pt), Grade 4 ARDS (1 pt) and Grade 3 fatigue (1 pt).
  • CONCLUSIONS: BI 2536 was well tolerated in relapsed SCLC pts, but demonstrated no convincing antitumor efficacy after stage I of the study.
  • Therefore, BI 2536 will not be assessed further as a single agent in SCLC.

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  • (PMID = 27964286.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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28. Qiao T, Zhou D: Concurrent radiotherapy combined with carboplatin and etoposide in limited stage small cell lung cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):7220

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent radiotherapy combined with carboplatin and etoposide in limited stage small cell lung cancer.
  • : 7220 Background: To observe the effects of concurrent radiotherapy combined with carboplatin and etoposide in limited stage small cell lung cancer.
  • METHODS: Ninty patients with limited stage small cell lung cancer were randomized into two groups, concurrent treatment group(group C) and alternating treatment group(group A).
  • All patients in two groups received radiotherapy (60Gy in 30 fractions) and six courses of chemotherapy (carboplatin and etoposide).
  • Radiotherapy was started in the first course of chemotherapy in group C.
  • Patients of group A were treated by radiation between the fourth and the fifth course of chemotherapy.
  • RESULTS: The median survival time was 26 months in group C and 19 months in group A.The 5-year survival rate was 27% in group C and 16% in group A.
  • The differences of two groups were significal(P<0.05).
  • CONCLUSIONS: Concurrent radiotherapy combined with carboplatin and etoposide can significantly improve median survival time and 5-year survival rate of patients with limited stage small cell lung cancer.

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  • (PMID = 28013895.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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29. Wymenga M, Biesma B, Vincent A, Dalesio O, Groen H: Platinum-based combination chemotherapy in the treatment of older non-small cell lung cancer (NSCLC) patients (pts): Is there a role for Complete Geriatric Assessment (CGA)? Final results from the prospective multicenter NVALT-3 study. J Clin Oncol; 2009 May 20;27(15_suppl):e20547

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Platinum-based combination chemotherapy in the treatment of older non-small cell lung cancer (NSCLC) patients (pts): Is there a role for Complete Geriatric Assessment (CGA)? Final results from the prospective multicenter NVALT-3 study.
  • : e20547 Background: Nearly 50% of NSCLC pts are aged over 70 years, but only few receive combination chemotherapy.
  • CGA is often advocated to assess the benefits and risks of chemotherapy in older pts.
  • METHODS: A total of 182 NSCLC pts ≥ 70 years with stage IIIb/IV disease were randomized to 4 cycles carboplatin/gemcitabine (CG) or carboplatin/paclitaxel (CP).
  • Pts with better Activities of Daily Living (ADL), instrumental ADL, or physical functioning were more likely to finish all chemotherapy cycles.
  • None of the CGA or QoL summary scores were associated with the occurrence of the other tox endpoints at p< 0.01.
  • CONCLUSIONS: Carboplatinum based combination chemotherapy in older NSCLC pts is feasible.
  • CGA predicts toxicity to a limited extent but does not add substantial information to PS.

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  • (PMID = 27961069.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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30. Perrone F, Benelli G, Lopatriello S, Portalone L, Salvati F, Zorat P, Negrini C: Cost of non-small cell lung cancer in Italy. Results of the longitudinal study ALCEA (Advanced Lung Cancer Economic Assessment). J Clin Oncol; 2004 Jul 15;22(14_suppl):8265

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cost of non-small cell lung cancer in Italy. Results of the longitudinal study ALCEA (Advanced Lung Cancer Economic Assessment).
  • : 8265 Background: Lung cancer is extremely common and its cost for society is not extensively studied.
  • ALCEA (Advanced Lung Cancer Economic Assessment) -an observational cost-of-illness study -has generated economic data on patients affected by NSCLC in an advanced stage, exploring both direct and indirect costs determined by this pathology in Italy.
  • METHODS: A total of 189 patients treated with first line chemotherapy (1<sup>st</sup> L), second line chemotherapy (2<sup>nd</sup> L) or supportive therapy (ST) were observed for a six-month period or until death.
  • Direct costs were measured according to consumption of healthcare resources (hospitalisations, specialist visits, drugs, diagnostic tests and laboratory tests) and costed according to current Italian tariffs.
  • A sample of total costs and an average per patient cost were produced and analysed for the 1<sup>st</sup> L, 2<sup>nd</sup> L and supportive therapy.
  • RESULTS: In 1<sup>st</sup> and 2<sup>nd</sup> line treatments the highest direct costs were determined by hospitalisations due to chemotherapy -with a mean cost per patient of € 4,350 and € 2,417 respectively - and by hospitalisations due to adverse eventsother disease related reasons-€ 3,819 and € 5,108 respectively.
  • For ST the highest costs were generated by hospitalisations occurred for reasons other than chemotherapy with a mean per patient cost of € 6,211.
  • CONCLUSIONS: ST may be a suggested strategy in the treatment of advanced NSCLC when chemotherapy appears to have a limited efficacy and worsening of patient performance status.
  • Infact, it implies a high level of utilization of healthcare resources and a significant productivity loss, despite many patients have already retired at the time of first diagnosis.

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  • (PMID = 28016698.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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31. Gadgeel SM, Shehadeh NJ, Ruckdeschel JC, Chaplen RA, Belzer K, Wozniak A: Gefitinib and celecoxib in patients with platinum refractory non-small cell lung cancer (NSCLC). J Clin Oncol; 2004 Jul 15;22(14_suppl):7094

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gefitinib and celecoxib in patients with platinum refractory non-small cell lung cancer (NSCLC).
  • : 7094 Background: Chemotherapy response rates in platinum refractory NSCLC are very limited.
  • METHODS: We are conducting a phase II study of gefitinib and celecoxib in patients with platinum refractory (progression on or within 3 months of platinum based therapy) NSCLC.
  • Each 4 week period is considered as a cycle.
  • Eligibility criteria include adequate hepatic, renal, bone marrow function; no sulfa or NSAID allergy; no current use of NSAIDS; no active thromboembolic disease.
  • RESULTS: 11 patients have been treated: median age 60 (44-74);gender 4M:7F;Stage IV-10; PS2-2; Adeno-5, Large cell-2;7 patients had received 2 prior chemotherapy regimens.
  • Of the 10 patients assessed for response 2 patients (20%) had a partial response and 3 patients (30%) had stable disease.
  • One patient developed interstitial pneumonitis and died 1 month after starting therapy.
  • One patient developed grade 3 diarrhea.

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  • (PMID = 28016160.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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32. Ross HJ: Topotecan consolidation after etoposide platinum for limited stage small cell lung cancer patients who do not receive prophylactic cranial irradiation. J Clin Oncol; 2009 May 20;27(15_suppl):7553

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Topotecan consolidation after etoposide platinum for limited stage small cell lung cancer patients who do not receive prophylactic cranial irradiation.
  • : 7553 Background: Small cell lung cancer (SCLC) accounts for approximately 15% of new lung cancer diagnoses in the US and about one third of patients present with limited stage (LD-SCLC).
  • Topotecan is active against SCLC and crosses the blood brain barrier suggesting that it might reduce brain metastases in this group.
  • METHODS: Eligible patients had declined or were ineligible for PCI after completing standard platinum etoposide chemotherapy with concurrent radiotherapy for LD-SCLC with at least a partial response (PR), had recovered from toxicity with PS 0-1, and had no evidence of brain metastases.
  • Brain metastases developed in 6 patients (30%) at a mean of 5.3 months (range 84-324 days).
  • At final data analysis, eight patients (40%) were alive without evidence of disease at 19 to 92.6 months.
  • One patient died with progressive disease and pneumonia after two cycles of topotecan.
  • Additional study of adjuvant topotecan in LD-SCLC patients who do not receive PCI may be warranted.

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  • (PMID = 27963341.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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33. Kotsakis AP, Tarhini A, Petro D, Flaugh R, Vallabhaneni G, Belani CP, Friedland D, Argiris A: Phase II study of RAD001 (everolimus) in previously treated small cell lung cancer (SCLC). J Clin Oncol; 2009 May 20;27(15_suppl):8107

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II study of RAD001 (everolimus) in previously treated small cell lung cancer (SCLC).
  • : 8107 Background: Everolimus (E) is an oral inhibitor of mammalian target of rapamycin (mTOR), a novel target for anti-cancer therapy that plays a central role in the PI3K/AKT signaling pathway and other pathways that mediate tumor growth, proliferation, and angiogenesis.
  • E has shown preclinical activity in SCLC cell lines and xenograft models.
  • METHODS: Eligibility included SCLC with disease progression after up to 2 prior chemotherapy regimens, ECOG performance status (PS) 0-2, and adequate bone marrow, liver, and kidney function.
  • Primary endpoint was the disease control rate (DCR), i.e. complete response (CR), partial response (PR) and stable disease (SD), after 2 cycles of E (6 weeks) in pts who received at least 1 cycle.
  • A 2-stage design was followed.
  • PI3K/AKT signaling pathway molecular biomarkers (AKT, pAKT, PTEN, P-S6, p-4E- BP1) will be evaluated on baseline tumor tissue.
  • RESULTS: 40 pts were enrolled; 14 males/26 females; median age 64 years (44-80); PS 0: 17, PS 1: 23; prior chemotherapy status: 1 prior regimen/sensitive relapse (i.e. relapse >60 days from completion of first-line chemotherapy): 23 pts; 1 prior regimen/refractory: 4 pts; 2 prior regimens: 13 pts.
  • Best response in 35 evaluable patients: 1 (3%) PR, 8 (23%) SD and 26 (74%) progression; DCR at 6 weeks was 26% with a duration of disease control of 2.7-6.3 months; median progression-free survival 1.4 months; and median overall survival 5.5 months.
  • CONCLUSIONS: E is well tolerated but has limited single-agent antitumor activity in unselected patients with pretreated SCLC.

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  • (PMID = 27964287.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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34. Gupta V, Weigand T, Rangineni R: Phase I-II dose escalation study of celecoxib (C) in combination with paclitaxel (T) and carboplatinum (CP) in non small cell lung cancer (NSCLC). J Clin Oncol; 2004 Jul 15;22(14_suppl):7310

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase I-II dose escalation study of celecoxib (C) in combination with paclitaxel (T) and carboplatinum (CP) in non small cell lung cancer (NSCLC).
  • : 7310 Background: Preclinical data suggests COX-2 inhibitors prevent development of cancer,shrink established tumors,and inhibit angiogenesis in dose dependent manner with "optimal"blood levels of 1.8-5ug/ml of celecoxib(C).
  • Clinical trials with C are limited to 800mg/d.
  • We studied the effect of 800, 1200,and 1600mg/d in two divided doses of C with fixed doses of carboplatinum( CP) and paclitaxel(T) in NSCLC.
  • METHODS: 34 patients with inoperable stage I-III and IV, with evaluable disease and PS 1,2 received C and prophylaxis with H2 blockers or proton pump inhibitors for 7d prior to CP AUC- 6 q4wks and T60mg/m2 weekly for at least 4 mo.Dose escalation of C was after 4 patients at each dose level.
  • 2 patients had received prior non-taxane therapy.
  • Blood levels of C were obtained by commercial HPLC assay in some patients after 4 hr dose of C.
  • There were18 patients with 800mg/d C, 10 with 1200mg/d C and 6 with 1600mg/d C.
  • Patients with StageI-III disease after 4mo induction chemotherapy received consolidation radiotherapy with or without chemotherapy.
  • RESULTS: The mean, range and n of blood levels( ng/ml ) of C were 1278,(600-2500),9;1866(1100-4200),6; and 2983,(1200-6100),7 respectively at 800,1200and 1600mg/d of C.
  • There were 22 patients evaluable for response with 3CR,6PR,10SD, 3 progressive after 4mo of therapy.
  • One stage IV patient with brain mets at 800mg of C died postop with GI bleed from incidental carcinoid of small bowel and one at 1600mg of C(blood level 1200ng/ml) after anticoagulation for DVT(INR 2.4), and one at 800mg mg of C from grade 4 neutropenia and pneumonia.
  • 3. "Optimal" blood levels of celecoxib may not be easily achieved at 800mg/d of celecoxib and may require therapeutic monitoring to properly asses impact in clinical trials.
  • 4. The therapeutic role of celecoxib in combination with chemotherapy or by itself requires ongoing investigation.

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  • (PMID = 28015039.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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35. Sadasivan R: A novel dosing schedule with gemcitabine, vinorelbine, and carboplatin for advanced non-small cell cancer of the lung. J Clin Oncol; 2004 Jul 15;22(14_suppl):7368

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A novel dosing schedule with gemcitabine, vinorelbine, and carboplatin for advanced non-small cell cancer of the lung.
  • : 7368 Background: Lung Cancer remains a leading cause of cancer death worldwide.
  • Patients with stages IIIB and IV non-small cell cancer of the lung have a very poor outcome.
  • Current treatment with chemotherapy using various two-drug regimens has shown limited benefits.
  • Three-drug regimens have considerable toxicities.
  • Understanding drug synergy between Gemcitabine and Carboplatin, and between Vinorelbine and Carboplatin, we have pioneered a novel dosing schedule that combines the three drugs on a fractionated weekly schedule.
  • METHODS: A phase II trial of this novel dosing schedule of a three-drug regimen using a fractionated weekly schedule is reported.
  • Patients received weekly treatments with Gemcitabine, Vinorelbine, and Carboplatin for a duration of 26 weeks.
  • Patients who met eligibility requirements which included stage IIIB and IV disease; performance status 0-2; ability to give consent; and adequate renal, hepatic, and cardiac function were enrolled on the protocol.
  • Patients who developed anemia were eligible for Darbepoetin or Epoetin.
  • Patients who developed neutropenia (ANC < 1,000) were given a week off treatment.
  • All patients had histologic confirmation of a non-small cell cancer of the lung.
  • Chemotherapy treatments consisted of Gemcitabine 800mg/m2 /week, Vinorelbine 15mg/m2 /week and Carboplatin AUC=2/week.
  • RESULTS: 6 patients (23%) are in complete remission; 11 patients (42%) have partial remission; 7 patients (27%) have stable disease, and 2 patients (8%) have failed treatment.
  • CONCLUSION: This novel regimen, which utilizes drug synergy, is well tolerated and holds promise for further study in a phase III trial.

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  • (PMID = 28015151.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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36. Craig MD, Rogers JS, Gupta N: Evaluation of PET scan in small cell lung cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):7214

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evaluation of PET scan in small cell lung cancer.
  • : 7214 Background: Small cell lung cancer remains a major health concern.
  • Prognosis, survival, and treatment options correlate with stage at diagnosis.
  • We hypothesize PET scanning may have a role in the staging procedure of patients with small cell lung cancer.
  • METHODS: A retrospective chart review of all patients between 1998-2003 diagnosed with small cell lung cancer was performed.
  • RESULTS: A total of 116 new patients with small cell lung cancer were reviewed.
  • Agreement between PET imaging and standard imaging for limited and extensive stage disease was 80% (35/44).
  • Five patients were diagnosed with limited stage disease instead of extensive disease based on PET results.
  • CT scan suggested adrenal metastasis in 4 patients, and opposite lung lesions in another, but the PET scan was not hypermetabolic.
  • All but one (who was lost to follow-up) were treated as limited stage disease with concurrent radiation and chemotherapy.
  • The four who remain have had survival and response suggestive of limited stage disease (alive at 6 months, 18 months, 32 months, and 3 years).
  • Two patients were increased from limited to extensive stage by PET scan results, one survived 9 months and the other is 5 months into therapy.
  • One patient had a biopsy proven false positive PET finding of lymphoid hyperplasia in the nasopharynx that would have increased the stage to extensive.
  • PET scan missed diffuse liver metastases in one patient (false negative), who was staged with limited disease.
  • PET scan was insensitive to detect brain metastasis (40% sensitive), although this did not change the patients' stage.
  • CONCLUSIONS: As in non-small cell lung cancer, changes in the adrenal glands seen on CT scan may be difficult to interpret.
  • A PET scan may be helpful to insure patients with small cell lung cancer are accurately staged and offered appropriate treatment.

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  • (PMID = 28013807.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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37. Spigel DR, Hainsworth JD, Burris HA, Dannaher C, Hon J, Morrissey LH, Greco FA: Long-term follow-up of limited stage small cell lung cancer patients treated with carboplatin-based chemotherapy and radiotherapy by the Minnie Pearl Cancer Research Network (MPCRN). J Clin Oncol; 2004 Jul 15;22(14_suppl):7222

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term follow-up of limited stage small cell lung cancer patients treated with carboplatin-based chemotherapy and radiotherapy by the Minnie Pearl Cancer Research Network (MPCRN).
  • : 7222 Background: Cisplatin plus etoposide and radiotherapy (RT) is considered standard therapy for good performance status (PS) patients with limited stage small cell lung cancer (SCLC) with a 5-year survival rate of about 20%.
  • From 1993 through 2001, 180 patients with limited-stage SCLC were entered on 4 sequential phase II trials of carboplatin-based chemotherapy with RT (see Table).
  • Eligible patients had limited stage SCLC; no prior systemic therapy; ECOG PS 0-2 (trials 1, 2, 3); PS 0-1 (trial 4), and adequate organ function.
  • RESULTS: 101 women and 79 men were enrolled with a median age of 60 years (range 35-85) years.
  • CONCLUSIONS: Carboplatin-based/RT regimens given in a community setting by the MPCRN for patients with limited stage SCLC produced a 5-year survival rate of 20%, which is comparable to standard cisplatin-based/RT regimens.

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  • (PMID = 28013900.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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38. Natale RB, Natale RB: Concurrent chemotherapy immediately following erlotinib (E) or gefitinib (G) induced apoptosis in previously untreated patients with advanced or metastatic non-small cell lung cancer (NSCLC). J Clin Oncol; 2009 May 20;27(15_suppl):e19014

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent chemotherapy immediately following erlotinib (E) or gefitinib (G) induced apoptosis in previously untreated patients with advanced or metastatic non-small cell lung cancer (NSCLC).
  • The predominance of anti-proliferative effects over the latter mechanism is postulated as the reason that no additional benefit was observed when either agent was given concurrently with 1<sup>st</sup> line chemotherapy in unselected NSCLC pts (INTACT 1 & 2, TALENT & TRIBUTE trials).
  • However, a subset analysis of TRIBUTE pts with a never smoking history suggested that improved survival may occur when the pt population is partially enriched to increase the proportion with an EGFR-TKI induced apoptotic effect (Miller VA.
  • We therefore hypothesized that pts demonstrating rapid tumor regression within a 3-4 week exposure to E or G represented a population highly enriched for the apoptotic effect and that immediate concurrent administration of chemotherapy would produce prolonged survival.
  • METHODS: Forty-one stage IIIB/IV pts, including 27 women and 14 men, median age 67 (range 41 to 88) with limited smoking history (21 never smokers, 20 former light smokers) were treated with E 100-150 mg/day (39 pts) or G 250 mg/day (2 pts) for an average of 26 days (range, 21-34) before response assessment.
  • Twenty-two pts achieved objective tumor responses (2 CRs, 20 PRs) and immediately received 4-6 cycles of platinum-based chemotherapy concurrently with continued E or G (group A).
  • E or G was discontinued in 19 pts not achieving objective response and platinum-based chemotherapy alone was given after a 10-14 day washout.
  • RESULTS: With a median follow-up of 24 mos, the median TTPs are 21+ mos and 7 mos and the median survivals are 31+ and 12 mos in groups A and B, respectively.
  • Results of EGFR mutation and other analyses in tumor tissue from 27 pts will be presented.
  • CONCLUSIONS: These data suggest that EGFR-TKI induced apoptosis may act synergistically with concurrent 1<sup>st</sup> line chemotherapy in pts with advanced or metastatic NSCLC and a new paradigm for incorporation of biologically targeted agents into chemotherapy regimens.

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  • (PMID = 27962621.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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39. Ibrahim T, Riccobon A, Petrini M, Stefanelli M, Tison C, Ridolfi R, Amadori D: The role of serum chromogranin A (CgA) in patients with small cell lung cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):7253

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of serum chromogranin A (CgA) in patients with small cell lung cancer.
  • : 7253 Background: Small cell lung cancer (SCLC) accounts for 20-25% of all lung cancers and often presents neuroendocrine characteristics.
  • Neuron-specific enolase (NSE) is the most widely used marker in this pathology and CgA, which belongs to the chromogranin-secretogranin family, is considered a multifunctional pro-hormone and is used for the diagnosis and follow up of neuroendrocrine tumors.
  • The aim of the present study was to define the prognostic role of CgA in SCLC and to assess its predictivity on response to therapy.
  • In the 26 SCLC patients, the median values of CgA and NSE were 23 U/l (range 0-421 U/l) and 29.9 U/l (range 5-134.5 U/l), respectively.
  • Correlation analysis between the two markers in patients showed a weak direct relation (r<sub>s</sub> = 0.35, p = 0.14).
  • Subgroup analysis as a function of stage and response to chemotherapy showed that median CgA values were similar in the 13 patients with limited disease (23 U/l, range 0-20 U/l) and in those with extended disease (14 U/l, range 0-421 U/l).
  • Lower CgA values were observed in chemotherapy-refractory patients than in responders (median 7 vs. 33 U/l).
  • CONCLUSIONS: Our preliminary results seem to indicate that there is no correlation between serum levels of CgA and NSE, and stage of disease.
  • Recruitment is ongoing to verify the potential role of CgA in predicting response to chemotherapy.

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  • (PMID = 28013911.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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40. Ono A, Naito T, Tsuya A, Nakamura Y, Murakami H, Kaira K, Takahashi T, Endo M, Yamamoto N: Serial pro-gastrin-releasing peptide and neuron specific enolase in predicting radiological response and overall survival of patients with small-cell lung cancer. J Clin Oncol; 2009 May 20;27(15_suppl):e22144

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Serial pro-gastrin-releasing peptide and neuron specific enolase in predicting radiological response and overall survival of patients with small-cell lung cancer.
  • : e22144 Background: Pro-gastrin-releasing peptide (ProGRP: P) and Neuron specific enolase (NSE: N) are specific serological markers in patients (pts) with small-cell lung cancer (SCLC).
  • The aim of this study was to investigate whether decreasing of these tumor markers correlate with radiological response and prognosis in pts with SCLC.
  • METHODS: Out of 194 newly diagnosed SCLC pts from September 2002- April 2008 at our institution, we retrospectively reviewed consecutive 118 pts who had measurable lesions and elevated baseline levels of P and N before initial therapy (IT) including chemotherapy or chemoradiotherapy, and survived more than one month.
  • P and N were measured on the first day of the every treatment course and after the final course of IT.
  • Computed tomography (CT) was documented on baseline and every 2 courses of IT.
  • RESULTS: Forty-six (38.9%) pts had limited stage disease (LD) and 72 (61.0%) pts had extensive stage disease (ED).
  • Both P and N levels at baseline were significantly correlated with the sum of longest diameter (SLD) in baseline CT; Spearman's ρ was 0.34 (P=0.001) and 0.44 (p<0.0001), respectively.
  • Also, the decreasing rate of P and N correlated with the decreasing rate of SLD, ρ= 0.45 (p<0.0001) and 0.21 (p=0.03), respectively.
  • Furthermore, the normalization of both P (<46pg/ml) and N (<10ng/ml) levels after 3 courses of IT was significantly associated with radiological response (p=0.015) including partial and complete response assessed by the Response Evaluation Criteria in Solid Tumors.
  • In Cox's multivariate analysis, the normalization of both P and N levels after 3 courses of the IT (p=0.03, hazard ratio: 0.47, 95% CI 0.23-0.93) was significantly associated with prolonged survival, when adjusted by age, PS, and disease extent (LD or ED).
  • In addition, the normalization of both P and N levels might be meaningful in predicting prognosis of SCLC pts.

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  • (PMID = 27963528.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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41. Xia B, Fu X, Cai X, Chen G, Yang H, Fan M, Zhao K: Involved-field radiotherapy for patients with limited small cell lung cancer: Patterns of local-regional failure and feasibility. J Clin Oncol; 2009 May 20;27(15_suppl):7554

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Involved-field radiotherapy for patients with limited small cell lung cancer: Patterns of local-regional failure and feasibility.
  • : 7554 Background: To investigate the feasibility of the involved-field radiotherapy in patients with limited-stage small cell lung cancer (LSCLC) according to the patterns of local failure, focused on the first local-regional failure.
  • All patients received combined chemotherapy (CHT) with cisplatin and etoposide, and thoracic RT (TRT) was generally delivered sequentially following one to three cycles of CHT and consisted of either 56 Gy in 40 fractions for 4 weeks or 55 Gy in 22 fractions for 4-5 weeks.
  • RESULTS: There were 89 patients completed the planed regimen and eligible for evaluating patterns of failure, 54 patients (57%) in 56 Gy cohort and 35 patients(43%) in 55 Gy cohort.
  • The overall survival and local progression-free survival rates for 89 patients at 2 years were 56% and 71%, respectively, with a median survival of 25.6 months.
  • 56 patients (63%) developed distant metastases and 21 patients (24%) developed local-regional failures: 12 in-field and 9 out-field.
  • Comparing the 56 Gy and 55 Gy cohorts, the rates of any thoracic, in-field and out-field failures were no difference significantly.
  • Whether improving accuracy for the initial evaluation of clinical stage could reduce out-field failure in supraclavicular fossa need to be investigated.

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  • (PMID = 27963342.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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42. Mack PC, Holland WS, Redman M, Lara PN Jr, Snyder LJ, Hirsch FR, Franklin WA, Kim ES, Herbst RS, Gandara DR: KRAS mutation analysis in cetuximab-treated advanced stage non-small cell lung cancer (NSCLC): SWOG experience with S0342 and S0536. J Clin Oncol; 2009 May 20;27(15_suppl):8022

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] KRAS mutation analysis in cetuximab-treated advanced stage non-small cell lung cancer (NSCLC): SWOG experience with S0342 and S0536.
  • : 8022 Background: KRAS mutations occur in NSCLC with a frequency of 15-25% and have been associated with a poor response to EGFR tyrosine kinase inhibitors.
  • In colorectal cancer, benefit from the EGFR-targeted monoclonal antibody cetuximab is largely limited to patients (pts) whose tumors are KRAS wild-type (WT).
  • RESULTS: For S0342, 45 archival tissues and 90 plasma specimens were analyzed.
  • In the limited sample set available from S0536, no associations were observed between KRAS status and clinical outcome [response rate: p=0.83; PFS: p=0.93; OS p=0.89].
  • CONCLUSIONS: These data suggest that KRAS mutations may not play a significant predictive role for cetuximab-based therapy in NSCLC, contrary to colorectal cancer.
  • KRAS analysis in recently completed phase III trials of chemotherapy ± cetuximab will be of interest to confirm these observations.

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  • (PMID = 27962804.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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43. Badzio A, Kurowski K, Karnicka-Mlodkowska H, Jassem J: The role of surgery in limited-disease small cell lung cancer (SCLC); a retrospective comparative study. J Clin Oncol; 2004 Jul 15;22(14_suppl):7221

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of surgery in limited-disease small cell lung cancer (SCLC); a retrospective comparative study.
  • : 7221 Background: Despite very high response rates to chemotherapy, prognosis of SCLC patients has remained poor with a median survival of only 12-14 months for limited disease.
  • High incidence of local relapses after chemotherapy in limited-stage SCLC led to reassessment of the role of local treatment in the multimodality management of this tumor Methods: We performed retrospective analysis of survival in two groups of limited-stage patients treated with either complete resection followed by chemotherapy (67 patients) or with conventional non-surgical management (67 patients).
  • In all patients managed with the resection, the diagnosis of SCLC was established only postoperatively.
  • The control group was selected using "pair-matched case-control" methodology, out of 176 limited-stage patients potentially suitable for surgery, but treated without resection.
  • Total series included 109 males and 25 females, 20 patients with T1 and 114 patients with T2 disease, 51 N0, 43 N1 and 40 N2 disease.
  • RESULTS: Median survival in patients treated with and without surgery was 22 months and 11 months, respectively (p<0.001).
  • Subset analysis confirmed significantly longer survival with surgery in all T and N categories, except for N2 disease.
  • Local relapse occurred in 15% and 55% of patients treated with and without surgery, respectively (p<0.001).
  • CONCLUSIONS: These data suggest that improved local control may possibly be translated into prolonged survival in selected limited-stage SCLC patients.
  • A randomised study assessing the role of surgery in combined modality treatment of those patients seems to be justified No significant financial relationships to disclose.

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  • (PMID = 28013898.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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44. Hennemann M, Sostruznik MH, Gaiger AM, Barrios CH: ERCC1 expression and survival in small cell lung cancer. J Clin Oncol; 2009 May 20;27(15_suppl):e19080

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] ERCC1 expression and survival in small cell lung cancer.
  • : e19080 Background: The excision repair cross-complementation group 1 (ERCC1) protein expression has been suggested as both predictive or prognostic according to the administration or not of cisplatin-based chemotherapy in non-small cell lung cancer.
  • It's role in small cell lung cancer (SCLC) is still uncertain.
  • METHODS: Forty four patients (pts) with diagnosis of SCLC were retrospectively analyzed.
  • Paraffin blocks were reviewed to reconfirm a SCLC diagnosis and submitted to semi-quantitative immunohistochemical (ICH) method to detect the ERCC1 protein.
  • All pts were treated with standard cisplatin-based chemotherapy and concomitant radiotherapy when appropriate according to stage.
  • RESULTS: The group of pts had 59% (n=26) men with a median age of 60,8 years (±10).
  • Staging revealed limited disease (LD) in 41% (n=18), extensive disease (ED) in 55% (n=24) and was not available from the chart review in 7% (n=3).
  • The median survival time (MST) was 15.84 (±9.73) months (mo) in LD; 8.39 (±8.53) mo in ED.
  • The 45% (n=10) of cases presenting with <50% of cells with positive staining had an overall survival of 13 (±10) mo.
  • In the group with positive ERCC1 expression, 45%(n=10) had LD and median survival of 17.1 (±7.8) mo [≥50% staining (n=6): median survival 12.1 (±3.9) mo; <50% staining (n=4): median survival 24.4 (±6.1) mo].
  • [≥50% staining (n=6): median survival 9.4 (±12) mo; <50% staining (n=5): median survival 6.1 (±1.5) mo].
  • CONCLUSIONS: In this group of SCLC pts ERCC1 expression by IHC does not seem to correlate with survival.

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  • (PMID = 27962190.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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45. Komaki R, Paulus R, Ettinger DS, Videtic GM, Bradley JD, Glisson BS, Choy H: A phase II study of accelerated high-dose thoracic radiation therapy (AHTRT) with concurrent chemotherapy for limited small cell lung cancer: RTOG 0239. J Clin Oncol; 2009 May 20;27(15_suppl):7527

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A phase II study of accelerated high-dose thoracic radiation therapy (AHTRT) with concurrent chemotherapy for limited small cell lung cancer: RTOG 0239.
  • : 7527 Background: Inter-group(IG) study 0096 showed that hyperfractionated and accelerated radiotherapy (HFXART) and concurrent etoposide/cisplatin(EP) improved 5-yr survival (26 %) for patients (pts) with limited small cell lung cancer (LSCLC) compared to daily treatment (TRT) with EP (16%), (p=0.04), HFXART/ EP still had high local failure (LF 40 %) and acute severe esophagitis (ASE) rate (27%).
  • Radiation Therapy Oncology Group (RTOG) 0239 was developed to improve local control (LC) and overall survival (OS) without increasing ASE.
  • METHODS: Eligibility included limited stage SCLC, age ≥ 18; P.S.
  • RT was given to large field to 28.8 Gy: 1.8 Gy/ fraction (Fx), 5 days (d) / wk for 16 Fx followed by BID with AP/PA fields in AM @ 1.8 Gy /Fx; boost with 2<sup>nd</sup> treatment in PM @ 1.8 Gy/Fx on d: 23-26; then off-cord boost, 1.8 Gy, BID, x last 5 days for a total dose of 61.2 Gy in 5 wks.
  • EP was started on day 1 of TRT with P, 60 mg/m<sup>2</sup> i.v; E, 120 mg/m<sup>2</sup> i.v.
  • ; E, 240 mg/m<sup>2</sup> p.o. d 2 and 3 or E 120 mg/m<sup>2</sup> i.v.
  • The median follow-up time is 19.0 months for all pts, and 30.4 months for pts still alive.
  • 2 treatment related deaths (2.8%) were reported.
  • Compliance with treatment was high and treatment-related death rate was similar to other chemoradiation regimens.

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  • (PMID = 27963294.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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46. Santos ES, Raez LE, Padmanabhan S, Rosado MF, Reis I: Novel combination chemotherapy with topotecan, doxorubicin and vincristine (TAV) in patients with advanced lung cancer. J Clin Oncol; 2004 Jul 15;22(14_suppl):7251

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Novel combination chemotherapy with topotecan, doxorubicin and vincristine (TAV) in patients with advanced lung cancer.
  • : 7251 Background: Topotecan has a role in the second-line therapy of small cell lung cancer (SCLC), and has activity in advanced non-small cell lung cancer (NSCLC).
  • The objective of this study was to determine the safety and maximum tolerated dose (MTD) of a novel combined chemotherapy regimen: topotecan (T), doxorubicin [Adriamycin (A)], and vincristine (V), for the development of Phase II trial.
  • METHODS: Patients (pts) with advanced SCLC or NSCLC who had incurable disease were enrolled.Pts should have failed palliative chemotherapy first, unless they have extensive disease (ED).
  • The schema used for therapy was: T was escalated from 0.75 mg/m<sup>2</sup> days 1-5 every four weeks; fixed doses of V and A were given at 1 mg/m<sup>2</sup> days 1 and 5, and 30 mg/m<sup>2</sup> day five only, respectively.
  • RESULTS: Fifteen pts were enrolled: 8 males and 7 females, with a median age of 53 years (35-72 years).
  • Nine pts had NSCLC and six SCLC.
  • No DLT were seen in the 0.75 mg/m<sup>2</sup> or 1 mg/m<sup>2</sup> cohorts.
  • Only 1/6 pts developed DLT in the 1.25 mg/m<sup>2</sup> cohort with grade 4 neutropenia and thrombocytopenia.
  • We stopped accrual in the 1.5 mg/m<sup>2</sup> cohort; we did not consider necessary to increase the dose of T because this is the dose commonly used as a single agent.
  • From the 9 pts with NSCLC: all were stage IV, 4/9 had received at least 2 lines of palliative chemotherapy, 4/9 had failed radiation, and 1/9 pt had a sustained PR (11%).
  • Among the 6 pts with SCLC: 5 had ED (3 already treated with chemotherapy), and one with limited disease that had relapsed.
  • CONCLUSIONS: The MTD for T is close to 1.25 mg/m<sup>2</sup> for this combination based on our experience and the data in the literature.
  • The activity seen in ED-SCLC (50% clinical benefit) may justify the development of a Phase II trial in this setting.

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  • (PMID = 28013916.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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47. Hesketh PJ, Chansky K, Lau DH, Crowley J, Gandara DR, Southwest Oncology Group: Sequential vinorelbine (V) and docetaxel (D) in advanced non-small cell lung cancer (NSCLC) patients age > 70, or with performance status (PS) 2: A SWOG phase II trial (S0027). J Clin Oncol; 2004 Jul 15;22(14_suppl):7056

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  • [Title] Sequential vinorelbine (V) and docetaxel (D) in advanced non-small cell lung cancer (NSCLC) patients age > 70, or with performance status (PS) 2: A SWOG phase II trial (S0027).
  • : 7056 Background: The value of V in elderly patients (pts) with advanced NSCLC was demonstrated in the ELVIS and MILES trials. (JNCI 1999,91:66; JNCI 2003,95:362) More limited evidence suggests value for V and D in PS 2 NSCLC pts.
  • Toxicity concerns have hindered enrollment of PS 2 and elderly pts into trials of combination chemotherapy.
  • Given the efficacy and tolerability of sequential chemotherapy in several settings, we conducted a phase II trial of sequential V and D.
  • METHODS: Eligibility: stage IIIB (pleural effusion)/stage IV NSCLC, age ≥ 70 and/or a PS of 2.
  • TREATMENT: V 25 mg/m2 days 1,8 every 21 days for 3 cycles immediately followed by D 35 mg/m2 days 1,8,15 every 28 days for 3 cycles.
  • Stage IV: 83%.
  • Treatment was generally well tolerated.
  • Survival in the PS 2 group is comparable, with less toxicity, to the experience of PS 2 pts in ECOG 1594 (Cancer 2001,92:2639) a trial of 4 platinum doublets.

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  • (PMID = 28016117.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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48. Schild SE, Stella PJ, Brooks BJ, Mandrekar S, Bonner JA, McGinnis WL, Nikcevich DA, Adjei AA, Jatoi A, Jett JR: The Results of combined modality therapy for limited stage small cell lung cancer (LD-SCLC) in the elderly. J Clin Oncol; 2004 Jul 15;22(14_suppl):7043

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The Results of combined modality therapy for limited stage small cell lung cancer (LD-SCLC) in the elderly.
  • : 7043 Background: A phase III trial was conducted by the NCCTG to determine whether chemotherapy (Etoposide and Cisplatin) plus either twice-daily radiotherapy(BID RT) or once-daily radiotherapy(QD RT) resulted in a better outcome for LD-SCLC.
  • No difference in survival was identified between the 2 treatment arms.
  • METHODS: This study included 263 patients with LD-SCLC and an ECOG performance status of ≤2 who were randomized to QD RT or split course BID RT.
  • The outcomes of the 209(79%) younger patients(<70 years old) were compared to the 54(21%) elderly patients(≥70 years old).
  • However, one specific toxicity, grade 4+ pneumonitis occurred in 0% of those <70 years compared to 6% of older patients(p=0.008).
  • These deaths occurred due to pneumonitis in 3 elderly patients and infection in the patient <70 years of age.
  • Fit elderly patients with LD-SCLC can receive combined modality therapy if carefully monitored.
  • Future studies should explore ways to decrease toxicity of therapy in all patients but especially in the elderly.

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  • (PMID = 28016065.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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49. Katakami N, Takakura S, Fujii H, Nishimura T, Umeda B: [Peripheral blood stem cell harvest in patients with limited stage small-cell lung cancer]. Gan To Kagaku Ryoho; 2000 Jun;27(6):865-71
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  • [Title] [Peripheral blood stem cell harvest in patients with limited stage small-cell lung cancer].
  • Chemotherapy plus granulocyte colony-stimulating factor (G-CSF) induced mobilization of peripheral blood stem cells (PBSC) was performed in patients with limited stage small-cell lung cancer.
  • Chemotherapy consisted of cisplatin/etoposide or cisplatin/adriamycin/etoposide.
  • Eight patients were successfully treated with high-dose chemotherapy consisting of ifosfamide, carboplatin and etoposide with PBSC transfusion.
  • The patients'-bone marrow reconstruction was rapid and no treatment-related death was observed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blood Component Removal. Carcinoma, Small Cell / therapy. Hematopoietic Stem Cell Transplantation. Lung Neoplasms / therapy
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Combined Modality Therapy. Doxorubicin / administration & dosage. Drug Administration Schedule. Etoposide / administration & dosage. Female. Granulocyte Colony-Stimulating Factor / administration & dosage. Hematopoietic Stem Cell Mobilization. Humans. Male. Middle Aged

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  • (PMID = 10897213.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin
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50. Bozóky G, Ruby E, Góhér I, Gábor G, Mohos A, Lengyel M: [The effect of chemo-radiotherapy on the remission and survival in patients with limited stage small cell lung cancer]. Orv Hetil; 2005 Jul 3;146(27):1433-8
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  • [Title] [The effect of chemo-radiotherapy on the remission and survival in patients with limited stage small cell lung cancer].
  • INTRODUCTION: The combined modality treatment used in case of limited stage small cell lung cancer assures the longest disease-free and average survival meanwhile maintaining an acceptable quality of life.
  • OBJECT: The authors examined whether the combined modality treatment in case of limited-stage small cell lung cancer affects the remission positively or not: they presumed that the therapeutic response, early partial or complete clinical and oncological remission develops earlier than in patients treated with chemotherapy.
  • The authors' other presumption was that the early therapeutic response could be the guarantee of the longest possible disease-free and average survival.
  • PATIENTS AND METHOD: Small cell lung cancer (SCLC) was proved in 72 patients (23 women, 49 men, average 53 year-olds) with histological and/or cytological examination.
  • Having examined which stage the patients were in, they proved to be in the limited stage.
  • The patients were divided into two groups at random: cytotoxic chemotherapy containing cisplatin + etoposide was used in 36 cases, meanwhile in the other 36 cases the chemotherapy was completed with early concurrent thoracic radiotherapy.
  • RESULTS: The therapeutic response happened earlier (early remission) in case of patients treated with chemo-radiotherapy than with chemotherapy treatment (average 10.4-12.6 weeks, SD = 1.22-1.99).
  • In patients with early remission receiving chemo-radiotherapy, the thoracic recidives and metastasis developed later (average 74.8 weeks, SD = 44.95), furthermore the average survival also proved to be longer (93.9 weeks, SD = 57.09).
  • The average time until the development of tumor recidives and metastasis in patients belonging to the chemotherapy group was 44.5 weeks (SD = 30.23), and the average survival was 67.4 weeks (SD = 32.77).
  • The result of the "log rank" test proved significant advantage for the chemo-radiotherapy group both for disease-free survival (p = 0.0010) and average survival (p = 0.0079 ).
  • Examination of treatment toxicity showed that one has to count primarily with esophagitis and pneumonitis related to the radiotherapy in patients receiving chemo-radiotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant / adverse effects. Cisplatin / administration & dosage. Disease-Free Survival. Esophagitis / etiology. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Staging. Pneumonia / etiology. Radiotherapy, Adjuvant / adverse effects. Remission Induction. Survival Analysis. Treatment Outcome

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  • (PMID = 16089103.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] Hungary
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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51. De Ruysscher D, Pijls-Johannesma M, Vansteenkiste J, Kester A, Rutten I, Lambin P: Systematic review and meta-analysis of randomised, controlled trials of the timing of chest radiotherapy in patients with limited-stage, small-cell lung cancer. Ann Oncol; 2006 Apr;17(4):543-52
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  • [Title] Systematic review and meta-analysis of randomised, controlled trials of the timing of chest radiotherapy in patients with limited-stage, small-cell lung cancer.
  • BACKGROUND: We undertook a systematic review and literature-based meta-analysis to determine whether the timing of chest radiotherapy may influence the survival of patients with limited-stage small-cell lung cancer (LS-SCLC).
  • MATERIALS: Eligible randomised controlled clinical trials were identified according to the Cochrane Collaboration Guidelines, comparing different timing of chest radiotherapy in patients with LS-SCLC.
  • Early chest irradiation was defined as beginning within 30 days after the start of chemotherapy.
  • When only trials were considered that used platinum chemotherapy concurrent with chest radiotherapy, a significantly higher 5-year survival was observed when chest radiotherapy was started within 30 days after the start of chemotherapy (2-year survival: OR: 0.73, 95% CI 0.51-1.03, P = 0.07; 5-year survival: OR: 0.64, 95% CI 0.44-0.92, P = 0.02).
  • This was even more pronounced when the overall treatment time of chest radiotherapy was less than 30 days.
  • CONCLUSIONS: There are indications that the 5-year survival rates of patients with LS-SCLC are in favour of early chest radiotherapy, with a significant difference if the overall treatment time of chest radiation is less than 30 days.

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  • [CommentIn] Cancer Treat Rev. 2006 Dec;32(8):652-5 [17008011.001]
  • (PMID = 16344277.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] England
  • [Number-of-references] 34
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52. Watkins JM, Wahlquist AE, Shirai K, Garrett-Mayer E, Aguero EG, Fortney JA, Sherman CA, Sharma AK: Factors associated with severe acute esophagitis from hyperfractionated radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys; 2009 Jul 15;74(4):1108-13
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  • [Title] Factors associated with severe acute esophagitis from hyperfractionated radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer.
  • PURPOSE: To describe incidence and identify factors associated with development of severe acute esophagitis during hyperfractionated radiotherapy with concurrent chemotherapy (BID-CRT) in patients with limited-stage small-cell lung cancer (SCLC).
  • METHODS AND MATERIALS: Retrospective cohort analysis of patient-, tumor-, and treatment-related variables was performed to identify factors associated with Radiation Therapy Oncology Group (RTOG) Grade 3 acute esophagitis.
  • Twice-daily chemoradiotherapy (BID-CRT) involved 45 Gy at 1.5 Gy per fraction, treated twice daily with concurrent platinum-based chemotherapy.
  • RESULTS: Between June 1999 and June 2007, 48 patients underwent curative intent BID-CRT for SCLC and were included in the analysis.
  • Median radiotherapy dose was 45 Gy (range, 42-51 Gy) delivered with a median 4 cycles of chemotherapy (range, 2-6).
  • RTOG Grade 3 acute esophagitis developed in 11 patients.
  • No patient developed Grade 4 or 5 esophagitis.
  • The most strongly associated dosimetric volume was the V15 (Grade 3 esophagitis rates of 15% vs. 64% for V15 <60% versus >or=60%, respectively).
  • CONCLUSIONS: RV-AUC is the factor most associated with development of Grade 3 acute esophagitis in limited stage SCLC patients receiving BID-CRT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Esophagitis / etiology. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Acute Disease. Aged. Aged, 80 and over. Area Under Curve. Carboplatin / administration & dosage. Carboplatin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Dose Fractionation. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Logistic Models. Male. Middle Aged. Retrospective Studies. Small Cell Lung Carcinoma / drug therapy. Small Cell Lung Carcinoma / pathology. Small Cell Lung Carcinoma / radiotherapy

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  • (PMID = 19084345.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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53. Lee SH, Ahn YC, Kim HJ, Lim DH, Lee SI, Nam E, Park SH, Park J, Lee KE, Park JO, Kim K, Kim WS, Jung CW, Im YH, Kang WK, Lee MH, Park K: Early concurrent chemoradiotherapy with prolonged oral etoposide and cisplatin for limited-stage small-cell lung cancer. Jpn J Clin Oncol; 2003 Dec;33(12):620-5
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  • [Title] Early concurrent chemoradiotherapy with prolonged oral etoposide and cisplatin for limited-stage small-cell lung cancer.
  • BACKGROUND: Combined chemoradiotherapy (CRT) is the standard treatment modality for limited-stage small-cell lung cancer (LSCLC), but the optimal timing of radiation is controversial.
  • We conducted a phase II trial of early concurrent CRT, starting from the very beginning of the first cycle of chemotherapy for previously untreated LSCLC.
  • METHODS: Chemotherapy was given for six cycles, each consisting of oral etoposide (50 mg/m(2) daily from day 1 to 14) and intravenous cisplatin (75 mg/m(2) on day 1), every 3 weeks.
  • Thoracic radiation therapy was given from day 1 of the first cycle of chemotherapy, administered at 2.0 Gy in 22 daily fractions to a total dose of 44 Gy.
  • Median overall survival was 14.9 months (95% CI, 11.4-18.3 months) and the median time to progression was 10.8 months (95% CI, 9.3-12.4 months) for the ITT population.
  • CONCLUSIONS: Early concurrent CRT, starting from the very beginning of the first cycle of chemotherapy with prolonged oral etoposide and cisplatin failed to show any improvement in survival compared with other CRT regimens.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Administration, Oral. Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged

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  • (PMID = 14769839.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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54. Videtic GM, Stitt LW, Dar AR, Kocha WI, Tomiak AT, Truong PT, Vincent MD, Yu EW: Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol; 2003 Apr 15;21(8):1544-9
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  • [Title] Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival.
  • PURPOSE: To determine the impact of continued smoking by patients receiving chemotherapy (CHT) and radiotherapy (RT) for limited-stage small-cell lung cancer (LSCLC) on toxicity and survival.
  • Treatment consisted of six cycles of alternating cyclophosphamide, doxorubicin, vincristine and etoposide, cisplatin (EP).
  • RT interruption during concurrent CHT/RT was used as the marker for treatment toxicity.
  • RT interruptions were recorded in 38 patients (20.5%), with a median duration of 5 days (range, 1 to 18 days).
  • Continuing smokers did not have a greater incidence of toxicity-related treatment breaks (P =.49), but those who continued to smoke and also experienced a treatment break had the poorest overall survival (median, 13.4 months; log-rank P =.0014).
  • Smoking did not have an impact on the rate of treatment interruptions attributed to toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / mortality. Carcinoma, Small Cell / therapy. Lung Neoplasms / mortality. Lung Neoplasms / therapy. Smoking / adverse effects. Smoking / mortality
  • [MeSH-minor] Actuarial Analysis. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 12697879.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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55. Cetingöz R, Cetinayak HO, Sen RC, Demiral AN, Akkoçlu A, Osma E, Kargi A, Oztop I, Onen A, Kinay M, Dokuz Eylül Lung Cancer Study Group: Prognostic factors in limited-stage small cell lung cancer of patients treated with combined modality approach. J BUON; 2006 Jan-Mar;11(1):31-7
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  • [Title] Prognostic factors in limited-stage small cell lung cancer of patients treated with combined modality approach.
  • PURPOSE: To evaluate the combined modality treatment results of patients with limited-stage small cell lung cancer (SCLC), who were treated and followed by the DELCSG.
  • PATIENTS AND METHODS: Sixty-three patients with limited-stage SCLC diagnosed between April 1991 and December 2002 were included.
  • All patients were treated with combined chemotherapy and thoracic radiotherapy.
  • Surgery was performed for diagnosis in 3 patients.
  • Four cycles of chemotherapy (median) were administered, composed of cisplatin-etoposide (CE) (26 patients), cyclophosphamide-vincristine-adriamycin (CAV) (10 patients) or alternated CE and CAV (18 patients).
  • Nine patients received various chemotherapy regimes other than CE and/or CAV.
  • Overall survival (OS) and progression-free survival (PFS) were calculated, beginning from the date of diagnosis and the end of radiotherapy, respectively.
  • RESULTS: Median follow-up time was 17 months (range 3-131).
  • During follow-up, 27 (43%) patients developed brain metastasis; among them only 3 had received PCI.
  • CONCLUSION: Our treatment results are in accordance with the relevant literature.
  • It is also concluded that PCI should be given to all patients with complete response to chemotherapy.
  • However, analysis of prognostic factors should be cautiously evaluated because of small number and heterogeneous distribution of patients in subgroups.
  • [MeSH-major] Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Cisplatin / therapeutic use. Combined Modality Therapy. Cranial Irradiation. Cyclophosphamide / therapeutic use. Doxorubicin / therapeutic use. Etoposide / therapeutic use. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Survival Rate. Vincristine / therapeutic use

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  • (PMID = 17318949.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; CAV protocol; VP-P protocol
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56. Bogart JA: Rationale for phase III trials of thoracic radiation therapy doses in limited-stage small-cell lung cancer. Clin Lung Cancer; 2008 Jul;9(4):202-5
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  • [Title] Rationale for phase III trials of thoracic radiation therapy doses in limited-stage small-cell lung cancer.
  • The optimal integration of thoracic radiation therapy with systemic chemotherapy in the treatment of limited stage small-cell lung cancer remains to be defined.
  • In March 2008, a phase III Intergroup study assessing high-dose thoracic radiation therapy in limited-stage small-cell lung cancer was activated in the United States, and a randomized study in Europe is also investigating a thoracic radiation therapy dose escalation.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy

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  • (PMID = 18650166.001).
  • [ISSN] 1525-7304
  • [Journal-full-title] Clinical lung cancer
  • [ISO-abbreviation] Clin Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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57. Pijls-Johannesma M, De Ruysscher D, Vansteenkiste J, Kester A, Rutten I, Lambin P: Timing of chest radiotherapy in patients with limited stage small cell lung cancer: a systematic review and meta-analysis of randomised controlled trials. Cancer Treat Rev; 2007 Aug;33(5):461-73
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  • [Title] Timing of chest radiotherapy in patients with limited stage small cell lung cancer: a systematic review and meta-analysis of randomised controlled trials.
  • BACKGROUND: We undertook a systematic review and literature-based meta-analysis to determine whether the timing of chest radiotherapy may influence the survival of patients with limited stage small cell lung cancer (LS-SCLC).
  • OBJECTIVES: To establish the most effective way of combining chest radiotherapy with chemotherapy for patients with limited-stage small cell lung cancer in order to improve long-term survival.
  • MATERIALS: Eligible studies were identified according to the Cochrane Collaboration Guidelines and were randomised controlled clinical trials comparing different timing of chest radiotherapy in patients with LS-SCLC.
  • Early chest irradiation was defined as beginning within 30 days after the start of chemotherapy.
  • When only trials were considered that used platinum chemotherapy concurrent with chest radiotherapy, significantly higher 2 and 5-year survival rates were observed when chest radiotherapy (RT) was started within 30 days after the start of chemotherapy (2-year survival: HR: 0.73, 95% CI 0.57-0.94, p=0.01; 5-year survival: HR: 0.65, 95% CI 0.45-0.93, p=0.02).
  • This was even more pronounced when the overall treatment time of chest radiotherapy was less than 30 days.
  • In studies that did not show a survival advantage by early chest radiation, a lower dose-intensity of chemotherapy in the early vs. late arm was observed.
  • CONCLUSIONS: When platinum-based chemotherapy concurrently with chest RT is used, the 2- and 5-year survival rates of patients with LS-SCLC may be in favour of early chest radiotherapy, with a significant difference if the overall treatment time of chest radiation is less than 30 days.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy. Thorax / radiation effects
  • [MeSH-minor] Humans. Neoplasm Staging. Randomized Controlled Trials as Topic. Time Factors

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  • (PMID = 17513057.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] England
  • [Number-of-references] 27
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58. Xenidis N, Kotsakis A, Kalykaki A, Christophyllakis Ch, Giassas S, Kentepozidis N, Polyzos A, Chelis L, Vardakis N, Vamvakas L, Georgoulias V, Kakolyris S: Etoposide plus cisplatin followed by concurrent chemo-radiotherapy and irinotecan plus cisplatin for patients with limited-stage small cell lung cancer: A multicenter phase II study. Lung Cancer; 2010 Jun;68(3):450-4
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  • [Title] Etoposide plus cisplatin followed by concurrent chemo-radiotherapy and irinotecan plus cisplatin for patients with limited-stage small cell lung cancer: A multicenter phase II study.
  • PURPOSE: The combination of irinotecan and cisplatin (IP) has shown at least comparable efficacy to that of etoposide/cisplatin (EP) in patients with extensive-stage small cell lung cancer.
  • We conducted a phase II study to evaluate the efficacy and tolerance of EP regimen followed by thoracic radiotherapy (TRT) and IP consolidation chemotherapy in patients with limited-stage small cell lung cancer.
  • PATIENTS AND METHODS: Thirty-three chemotherapy-naive patients with limited-stage small cell lung cancer (LS-SCLC) were treated with etoposide 100mg/m(2) on days 1-3 and cisplatin 80mg/m(2) on day 1.
  • Radiotherapy was given 3 weeks after the first treatment cycle concurrently with weekly cisplatin 20mg/m(2) on day 1 and etoposide 50mg/m(2) on day 4 within 5-6 weeks, followed by three courses of irinotecan 60mg/m(2) on days 1, 8, and 15 and cisplatin 60mg/m(2) on day 1 of a 4-week cycle.
  • RESULTS: There were no treatment-related deaths.
  • The major toxicity observed during consolidation chemotherapy was grades 3-4 neutropenia which affected 42% of patients.
  • After a median follow-up period of 35.7 months (range: 9.6-41.2 months), the median survival time was 19 months (95% CI: 14.5-23.5 months), the median time to tumor progression 8.3 months and the 1- and 2-year survival rates 72% and 27.5%, respectively.
  • CONCLUSIONS: Consolidation chemotherapy with IP following concurrent EP plus TRT is a safe and with acceptable toxicity regimen and deserves further phase III testing in patients with LS-SCLC.
  • [MeSH-major] Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Small Cell Lung Carcinoma / drug therapy. Small Cell Lung Carcinoma / radiotherapy
  • [MeSH-minor] Aged. Camptothecin / administration & dosage. Camptothecin / adverse effects. Camptothecin / analogs & derivatives. Cisplatin / administration & dosage. Cisplatin / adverse effects. Drug Therapy, Combination. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Neutropenia / etiology. Radiotherapy, Adjuvant

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  • [Copyright] Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
  • (PMID = 19783319.001).
  • [ISSN] 1872-8332
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 7673326042 / irinotecan; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
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59. Segawa Y, Ueoka H, Kiura K, Tabata M, Takigawa N, Hiraki Y, Watanabe Y, Yonei T, Moritaka T, Hiyama J, Hiraki S, Tanimoto M, Harada M, Okayama Lung Cancer Study Group: Phase I/II study of altered schedule of cisplatin and etoposide administration and concurrent accelerated hyperfractionated thoracic radiotherapy for limited-stage small-cell lung cancer. Lung Cancer; 2003 Jul;41(1):13-20
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  • [Title] Phase I/II study of altered schedule of cisplatin and etoposide administration and concurrent accelerated hyperfractionated thoracic radiotherapy for limited-stage small-cell lung cancer.
  • To improve the efficacy of a combination of cisplatin and etoposide and concurrent accelerated twice-daily thoracic radiotherapy against limited-stage small-cell lung cancer, we conducted a phase I/II study using an altered schedule of chemotherapy administration.
  • Chemotherapy consisted of four cycles of cisplatin (days 1 and 8) and etoposide (days 1, 2, 8, and 9) every 4 weeks.
  • Accelerated hyperfractionated thoracic radiation (1.5 Gy twice daily x 30 fractions, total dose of 45 Gy) was concurrently given with the first cycle of chemotherapy.
  • By a median follow-up time of 29 months, median radiation-outfield progression-free survival was 13.4 months, while radiation-infield progression-free survival did not reach median value.
  • The median overall survival time was 22.9 months, with survival rate of 48.4% at 2 years.
  • However, the insufficient distant control suggests a need for development of more active chemotherapy regimens.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Cisplatin / administration & dosage. Etoposide / administration & dosage. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Aged. Cohort Studies. Combined Modality Therapy. Drug Administration Schedule. Female. Follow-Up Studies. Humans. Male. Middle Aged. Treatment Outcome

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  • (PMID = 12826307.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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60. Yee D, Halperin R, Hanson J, Nijjar T, Butts C, Smylie M, Reiman T, Roa W: Phase I study of hypofractionated dose-escalated thoracic radiotherapy for limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys; 2006 Jun 1;65(2):466-73
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  • [Title] Phase I study of hypofractionated dose-escalated thoracic radiotherapy for limited-stage small-cell lung cancer.
  • PURPOSE: To determine the maximal tolerated dose of hypofractionated thoracic radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer patients.
  • Radiotherapy was given in two phases: patients initially received 20 Gy in 10 fractions to gross tumor plus uninvolved mediastinal nodes, followed by a boost to gross disease of 30, 38, or 42 Gy in 15 fractions.
  • All patients received four cycles of cisplatin (25 mg/m2) and etoposide (100 mg/m2) chemotherapy.
  • Radiotherapy commenced with Day 1 of Cycle 2 of chemotherapy.
  • There were no treatment-related deaths.
  • There was one Grade 3 acute nonhematologic toxicity in the 50-Gy group.
  • Of the 6 patients given 58 Gy, 3 experienced acute Grade 3 esophagitis.
  • With a median follow-up of 7 months, median overall survival was 9.5 months.
  • CONCLUSIONS: The maximal tolerated dose of thoracic radiotherapy with concurrent chemotherapy on this trial was 50 Gy in 25 daily fractions.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy. Maximum Tolerated Dose
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Radiotherapy, Conformal / adverse effects. Radiotherapy, Conformal / methods. Treatment Outcome

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  • (PMID = 16563653.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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61. Uno T, Sumi M, Sawa Y, Teshima T, Hara R, Ikeda H, Inoue T, Japanese PCS Working Subgroup of Lung Cancer: Process of care and preliminary outcome in limited-stage small-cell lung cancer: results of the 1995-1997 patterns of care study in Japan. Int J Radiat Oncol Biol Phys; 2003 Mar 1;55(3):626-32
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  • [Title] Process of care and preliminary outcome in limited-stage small-cell lung cancer: results of the 1995-1997 patterns of care study in Japan.
  • PURPOSE: To evaluate the practice process using the national average (NA); to compare differences in the process of care by age group; and to provide a preliminary outcome data for limited-stage small-cell lung cancer in Japan.
  • METHODS AND MATERIALS: The Patterns of Care Study conducted a nationwide survey of the care process for Stage I-III small-cell lung cancer in Japan.
  • Patients were divided into three age groups: <65 years (younger group, n = 73); between 65 and 74 years (intermediate group, n = 81); and >or=75 years (elderly group, n = 20).
  • RESULTS: The NA for the total dose was 49.0 Gy, and for use of photon energy >or=6 MV, chemotherapy, and prophylactic cranial irradiation was 77.3%, 93.2%, and 1.69%, respectively.
  • Only 37% of patients received chemotherapy and thoracic RT concurrently.
  • The proportion of patients who received chemotherapy and RT concurrently was 44%, 27%, and 25% of the younger, intermediate, and elderly groups, respectively (p = 0.029).
  • Variables found to have a significant impact on survival by multivariate analysis were the use of chemotherapy (p = 0.030), age (p = 0.032), and T stage (p = 0.042).
  • The results demonstrated that patient age significantly influenced the process of chemotherapy such as the use of etoposide and cisplatin for limited-stage small-cell lung cancer in Japan.
  • More concurrent chemotherapy and thoracic RT and the application of prophylactic cranial irradiation for complete responders need to be investigated in the future.
  • [MeSH-major] Benchmarking. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy

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  • (PMID = 12573749.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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62. Bremnes RM, Sundstrøm S, Vilsvik J, Aasebø U, Norwegian Lung Cancer Study Group: Multicenter phase II trial of paclitaxel, cisplatin, and etoposide with concurrent radiation for limited-stage small-cell lung cancer. J Clin Oncol; 2001 Aug 01;19(15):3532-8
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  • [Title] Multicenter phase II trial of paclitaxel, cisplatin, and etoposide with concurrent radiation for limited-stage small-cell lung cancer.
  • PURPOSE: To investigate the feasibility, efficacy, and safety of adding paclitaxel to cisplatin/etoposide chemotherapy and concurrent thoracic radiotherapy (TRT) in treatment of limited-stage small-cell lung cancer (LD-SCLC).
  • PATIENTS AND METHODS: Patients received five courses of chemotherapy (paclitaxel 175 mg/m2 1-hour intravenous [IV] infusion day 1; cisplatin 50 mg/m(2) IV day 1; etoposide 100 mg/m2 IV day 1; oral etoposide 100 mg bid days 2 to 5) at 3-week intervals.
  • TRT (42 Gy administered in 15 fractions) was administered concurrent with chemotherapy cycle 3.
  • All patients were evaluated before starting TRT and 4 weeks after termination of chemotherapy.
  • The 1- and 2-year disease-specific survival rates were 69% and 37%, respectively.
  • One treatment-related death occurred as a result of severe neutropenia and septicemia.
  • CONCLUSION: This novel multimodal regimen is effective and well tolerated in patients with LD-SCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Male. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Paclitaxel / adverse effects

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  • (PMID = 11481360.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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63. Cao KJ, Huang HY, Tu MC, Pan GY: Long-term results of prophylactic cranial irradiation for limited-stage small-cell lung cancer in complete remission. Chin Med J (Engl); 2005 Aug 5;118(15):1258-62
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  • [Title] Long-term results of prophylactic cranial irradiation for limited-stage small-cell lung cancer in complete remission.
  • BACKGROUND: Brain metastasis is one of the most important causes of treatment failure in patients with small cell lung cancer (SCLC).
  • This study was conducted to evaluate the effects of prophylactic cranial irradiation (PCI) on survival and brain metastases for patients with limited stage small cell lung cancer in complete remission.
  • METHODS: Fifty one patients with limited stage SCLC in complete remission after chemoradiotherapy were randomly divided into PCI group (n = 26) and control group (n = 25).
  • Patients in the PCI group received PCI at a dose of 25.2 to 30.6 Gy in 1.8 to 2.0 Gy per fraction.
  • RESULTS: There was no significant difference in clinical characteristics of patients such as age, sex, effect of treatment before PCI between the two groups.
  • CONCLUSION: For patients with limited stage SCLC responding completely to chemotherapy plus radiotherapy, PCI can decrease the incidence of brain metastases and improve survival rate.
  • [MeSH-major] Brain Neoplasms / prevention & control. Carcinoma, Small Cell / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Cranial Irradiation. Female. Humans. Male. Middle Aged

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  • (PMID = 16117878.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
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64. Fried DB, Morris DE, Poole C, Rosenman JG, Halle JS, Detterbeck FC, Hensing TA, Socinski MA: Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol; 2004 Dec 1;22(23):4837-45
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  • [Title] Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer.
  • PURPOSE: We employed meta-analytic techniques to evaluate early (E) versus late (L) timing of thoracic radiation therapy (RT) in limited-stage small-cell lung cancer (LS-SCLC).
  • METHODS: Randomized trials published after 1985 addressing timing of RT relative to chemotherapy in LS-SCLC were included.
  • RESULTS: Overall survival (OS) RRs for all studies were 1.17 at 2 years (95% CI, 1.02 to 1.35; P = .03) and 1.13 at 3 years (95% CI, 0.92 to 1.39; P = .2), indicating a significantly increased 2-year survival for ERT versus LRT patients and suggestive of a similar trend at 3 years.
  • Studies using platinum-based chemotherapy had OS RRs of 1.30 (95% CI, 1.10 to 1.53; P = .002) and 1.35 (95% CI, 1.07 to 1.70; P = .01) at 2 and 3 years, respectively, favoring ERT.
  • Studies using nonplatinum-based chemotherapy regimens had nonsignificant differences in OS.
  • CONCLUSION: A small but significant improvement in 2-year OS for ERT versus LRT in LS-SCLC was observed, similar to the benefit of adding RT to chemotherapy or prophylactic cranial irradiation.
  • A greater difference was evident for hyperfractionated RT and platinum-based chemotherapy.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / mortality. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Confidence Intervals. Dose Fractionation. Dose-Response Relationship, Radiation. Humans. Neoplasm Staging. Odds Ratio. Pneumonectomy / methods. Prognosis. Radiotherapy Dosage. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Risk Assessment. Survival Analysis. Treatment Outcome

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  • [ErratumIn] J Clin Oncol. 2005 Jan 1;23(1):248
  • (PMID = 15570087.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] United States
  • [Number-of-references] 39
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65. Uno T, Sumi M, Ishihara Y, Numasaki H, Mitsumori M, Teshima T, Japanese PCS Working Subgroup of Lung Cancer: Changes in patterns of care for limited-stage small-cell lung cancer: results of the 99-01 patterns of care study-a nationwide survey in Japan. Int J Radiat Oncol Biol Phys; 2008 Jun 1;71(2):414-9
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  • [Title] Changes in patterns of care for limited-stage small-cell lung cancer: results of the 99-01 patterns of care study-a nationwide survey in Japan.
  • BACKGROUND: This study was undertaken to analyze the practice process of thoracic radiotherapy (TRT) and evaluate changes in patterns of care for patients with limited-stage small-cell lung cancer (LS-SCLC) in Japan.
  • METHODS AND MATERIALS: The Patterns of Care Study (PCS) conducted the second nationwide survey of care process for patients with LS-SCLC treated by using TRT between 1999 and 2001.
  • RESULTS: The PCS collected data for 139 patients with LS-SCLC (man-woman ratio, 5:1; median age, 69 years; age > 70 years, 43%; Karnofsky Performance Status > 70, 73%; and Stage III, 88%).
  • Median total dose was 50 Gy.
  • Three-dimensional conformal therapy was used with 12% of patients.
  • Computed tomography simulation was performed in 40% of cases.
  • Concurrent chemotherapy and TRT (CCRT) was used for 94 patients (68%).
  • Compared with the previous PCS 95-97, significant increases in the use of CCRT (34-68%; p < 0.0001), twice-daily TRT (15-44%; p < 0.0001), and PCI (1.7-8.6%; p =0.0045) were observed, although the absolute number of patients receiving PCI was still extremely low.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy. Practice Patterns, Physicians'
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy / methods. Computer Simulation. Cranial Irradiation. Female. Health Care Surveys. Humans. Japan. Karnofsky Performance Status. Male. Middle Aged. Neoplasm Staging. Radiation Oncology / standards. Radiation Oncology / trends. Radiotherapy / methods. Radiotherapy / standards. Radiotherapy, Conformal. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 18164865.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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66. Berthelet E, Truong PT, Lesperance M, Lim JT, Wai ES, MacNeil MV, Liu M, Joe H, Olivotto IA: Examining time intervals between diagnosis and treatment in the management of patients with limited stage small cell lung cancer. Am J Clin Oncol; 2006 Feb;29(1):21-6
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  • [Title] Examining time intervals between diagnosis and treatment in the management of patients with limited stage small cell lung cancer.
  • OBJECTIVE: To examine time intervals between diagnosis and treatment of limited stage small cell lung cancer (L-SCLC) and to evaluate its effect on clinical outcomes.
  • MATERIALS AND METHODS: Data on 166 patients with L-SCLC referred to a regional cancer center between January 1991 and December 1999 were analyzed.
  • The time intervals studied were defined as: interval A, first abnormal chest x-ray to pathologic diagnosis: interval B, diagnosis to first oncology consultation; interval C, oncology consultation to first day of thoracic radiotherapy (RT); interval D, oncology consultation to first day of chemotherapy; and interval E, first day of chemo to first day of RT.
  • Cox proportional hazards models were used to examine associations between the time intervals and thoracic relapse (TR) and overall survival (OS) outcomes.
  • Logistic regression analysis was used to model associations between time and complete response (CR) rates.
  • RESULTS: The median time duration of intervals A to E were 20, 12, 63.5, 15, and 48 days, respectively.
  • When time was analyzed as a continuous variable, no statistically significant association between the interval lengths and outcomes studied was observed.
  • Dichotomizing each interval using the median value as cut-off revealed that interval A >20 days was significantly associated with improved CR (odds ratio = 3.573; P = 0.027) whereas interval B >12 days was associated with a trend toward lower CR (odds ratio = 0.348; P = 0.073).
  • CONCLUSIONS: Short median times from first abnormal chest x-ray to diagnosis and from diagnosis to oncology consultation indicate that L-SCLC patients were diagnosed and referred promptly in the community setting.
  • OS and TR appeared independent of the time intervals analyzed.
  • Individual variations in disease presentation and tumor biology may explain the observed associations between early pathologic diagnosis and inferior CR rates.
  • [MeSH-major] Carcinoma, Small Cell / diagnosis. Carcinoma, Small Cell / therapy. Lung Neoplasms / diagnosis. Lung Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Cranial Irradiation. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiography, Thoracic. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 16462498.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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67. Bogart JA, Herndon JE 2nd, Lyss AP, Watson D, Miller AA, Lee ME, Turrisi AT, Green MR, Cancer and Leukemia Group B study 39808: 70 Gy thoracic radiotherapy is feasible concurrent with chemotherapy for limited-stage small-cell lung cancer: analysis of Cancer and Leukemia Group B study 39808. Int J Radiat Oncol Biol Phys; 2004 Jun 1;59(2):460-8
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  • [Title] 70 Gy thoracic radiotherapy is feasible concurrent with chemotherapy for limited-stage small-cell lung cancer: analysis of Cancer and Leukemia Group B study 39808.
  • PURPOSE: To prospectively evaluate the feasibility of delivering 70 Gy once-daily thoracic radiotherapy (TRT), concurrent with chemotherapy, in the treatment of limited-stage small-cell lung cancer (L-SCLC).
  • TRT (70 Gy, 2 Gy/fx/7 weeks) was initiated with the first cycle of carboplatin and etoposide.
  • There was one treatment-related fatality.
  • The response rate to all therapy was 92% and the median overall survival is 22.4 months (95% confidence interval 16.1, infinity ).
  • Twenty-eight patients remain alive with a median follow-up of 24.7 months.
  • CONCLUSION: 70 Gy once-daily TRT can be delivered safely in the cooperative group setting for patients with L-SCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Small Cell Lung Carcinoma / drug therapy. Small Cell Lung Carcinoma / radiotherapy
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Feasibility Studies. Female. Granulocyte Colony-Stimulating Factor / therapeutic use. Humans. Male. Middle Aged. Paclitaxel / administration & dosage. Prospective Studies. Radiotherapy Dosage. Remission Induction. Survival Analysis. Topotecan / administration & dosage

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2004 Dec 1;60(5):1661-2; author reply 1662-3 [15590201.001]
  • (PMID = 15145163.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA03927; United States / NCI NIH HHS / CA / CA04326; United States / NCI NIH HHS / CA / CA04457; United States / NCI NIH HHS / CA / CA11789; United States / NCI NIH HHS / CA / CA12046; United States / NCI NIH HHS / CA / CA12449; United States / NCI NIH HHS / CA / CA16450; United States / NCI NIH HHS / CA / CA21060; United States / NCI NIH HHS / CA / CA31946; United States / NCI NIH HHS / CA / CA31983; United States / NCI NIH HHS / CA / CA33601; United States / NCI NIH HHS / CA / CA35091; United States / NCI NIH HHS / CA / CA37135; United States / NCI NIH HHS / CA / CA41287; United States / NCI NIH HHS / CA / CA47555; United States / NCI NIH HHS / CA / CA47577; United States / NCI NIH HHS / CA / CA77298; United States / NCI NIH HHS / CA / CA77406; United States / NCI NIH HHS / CA / CA77658
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor; 7M7YKX2N15 / Topotecan; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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68. Watkins JM, Wahlquist AE, Zauls AJ, Shirai K, Garrett-Mayer E, Aguero EG, Silvestri GA, Sherman CA, Sharma AK: Involved-field radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer: disease control, patterns of failure and survival. J Med Imaging Radiat Oncol; 2010 Oct;54(5):483-9
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  • [Title] Involved-field radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer: disease control, patterns of failure and survival.
  • INTRODUCTION: Major randomised trials have employed elective nodal irradiation as part of combined modality therapy for limited-stage small-cell lung cancer (SCLC).
  • The present investigation describes patterns of failure, disease control, and survival outcomes for involved-field radiotherapy with concurrent chemotherapy, without elective irradiation of uninvolved mediastinal nodal regions.
  • METHODS: Retrospective analysis of SCLC patients treated with curative-intent accelerated, twice-daily radiotherapy and concurrent platinum-based chemotherapy at an academic institution.
  • Treatment fields were reviewed, and patients who completed ≥42 Gy in 1.5 Gy twice-daily fractions to involved fields (without elective irradiation of uninvolved mediastinal lymphatic regions) were included in the present analysis.
  • Initial patterns of failure, disease control and overall survival were recorded.
  • All but one patient completed three to four cycles of chemotherapy, and 10 patients experienced grade 3 acute esophagitis.
  • At a median survivor follow-up of 35 months (range 5.5-91.9), 22 patients were alive (15 without recurrence) and 30 had died (23 of/with disease, four of unknown cause, two of other cause and one of treatment toxicity).
  • Initial site(s) of disease failure were loco-regional only (11 patients), distant only (14) and loco-regional plus distant (3).
  • There were no cases of isolated out-of-field mediastinal recurrence in the absence of supraclavicular or more distant disease.
  • The estimated 3-year disease-free and overall survivals were 36% and 44%, respectively.
  • CONCLUSIONS: Involved-field radiotherapy did not appear to have an adverse impact on the anticipated patterns of failure, disease control, or overall survival in this population of limited-stage SCLC patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiotherapy Dosage. Retrospective Studies. Survival Rate. Treatment Outcome

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  • [Copyright] © 2010 The Authors. Journal of Medical Imaging and Radiation Oncology © 2010 The Royal Australian and New Zealand College of Radiologists.
  • (PMID = 20958948.001).
  • [ISSN] 1754-9485
  • [Journal-full-title] Journal of medical imaging and radiation oncology
  • [ISO-abbreviation] J Med Imaging Radiat Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / K24 CA120494
  • [Publication-type] Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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69. Schreiber D, Rineer J, Weedon J, Vongtama D, Wortham A, Kim A, Han P, Choi K, Rotman M: Survival outcomes with the use of surgery in limited-stage small cell lung cancer: should its role be re-evaluated? Cancer; 2010 Mar 1;116(5):1350-7
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  • [Title] Survival outcomes with the use of surgery in limited-stage small cell lung cancer: should its role be re-evaluated?
  • BACKGROUND: Although chemotherapy and radiation therapy currently are recommended in limited-stage small cell lung cancer (L-SCLC), several small series have reported favorable survival outcomes in patients who underwent surgical resection.
  • METHODS: The Surveillance, Epidemiology, and End Results (SEER) registry was used to identify patients who were diagnosed with L-SCLC between 1988 and 2002 coded by SEER as localized disease (T1-T2Nx-N0) or regional disease (T3-T4Nx-N0).
  • Surgery was associated more commonly with T1/T2 disease (P < .001).
  • Surgery was associated with improved survival for both localized disease and regional disease with improvements in median survival from 15 months to 42 months (P < .001) and from 12 months to 22 months (P < .001), respectively.
  • Lobectomy was associated with the best outcome (P < .001).
  • Patients with localized disease who underwent lobectomy with had a median survival of 65 months and a 5-year OS rate of 52.6%; whereas patients who had regional disease had a median survival of 25 months and a 5-year OS rate of 31.8%.
  • On multivariate analysis, the benefit of surgery varied in a time-dependant fashion.
  • However, the benefit of lobectomy remained across all time intervals (P = .002).
  • CONCLUSIONS: The use of surgery, and particularly lobectomy, in selected patients with L-SCLC was associated with improved survival outcomes.
  • Future prospective studies should consider the role of surgery as part of the multimodality management of this disease.
  • [MeSH-major] Lung Neoplasms / surgery. Small Cell Lung Carcinoma / surgery
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. SEER Program. Survival Rate

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  • (PMID = 20082453.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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70. De Ruysscher D, Vansteenkiste J: Chest radiotherapy in limited-stage small cell lung cancer: facts, questions, prospects. Radiother Oncol; 2000 Apr;55(1):1-9
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  • [Title] Chest radiotherapy in limited-stage small cell lung cancer: facts, questions, prospects.
  • OBJECTIVE AND STUDY DESIGN: Limited-disease small cell lung cancer (LD-SCLC) is initially very sensitive to both radiotherapy and chemotherapy.
  • However, the 5-year survival is generally only 10-15%, with most patients failing with therapy refractory relapses, both locally and in distant sites.
  • The addition of chest irradiation to chemotherapy increases the absolute survival by approximately 5%.
  • RESULTS: No strong data support total radiation doses over 50 Gy.
  • According to one phase III trial and several retrospective studies, increasing the volume of the radiation fields to the pre-chemotherapy tumour volume instead of the post-chemotherapy volume does not improve local control.
  • CONCLUSIONS: The total time in which the entire combined-modality treatment is delivered may be important.
  • Some phase III trials support the use of accelerated chest radiation together with cisplatin-etoposide chemotherapy, delivered from the first day of treatment, although no firm conclusions can be drawn from the available data.
  • The best results are reported in studies in which the time from the start of treatment to the end of the radiotherapy was less than 30 days.
  • This has to be taken into consideration when treatment modalities incorporating new chemotherapeutic agents and radiotherapy are considered.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Clinical Trials, Phase III as Topic. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Neoplasm Recurrence, Local / pathology. Radiotherapy Dosage. Randomized Controlled Trials as Topic. Retrospective Studies. Survival Rate. Time Factors. Treatment Outcome

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  • (PMID = 10788682.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] IRELAND
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 53
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71. Ganti AK, Zhen W, Kessinger A: Limited-stage small-cell lung cancer: therapeutic options. Oncology (Williston Park); 2007 Mar;21(3):303-12; discussion 312, 315-8, 323
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  • [Title] Limited-stage small-cell lung cancer: therapeutic options.
  • Almost 40% of patients with newly diagnosed small-cell lung cancer (SCLC) have disease confined to the ipsilateral hemithorax and within a single radiation port, i.e., limited-stage disease.
  • The median survival for this group of patients after treatment is approximately 15 months, with one in every four patients surviving 2 years.
  • Current optimal treatment consists of chemotherapy with platinum/etoposide, given concurrently with thoracic radiation.
  • Surgery may represent an option for very early-stage disease, but its added value is uncertain.
  • Prophylactic cranial irradiation (PCI) is used for patients with limited-stage SCLC who have achieved a complete response following initial therapy, as it decreases the risk of brain metastases and provides an overall survival benefit.
  • Newer targeted agents are currently being evaluated in this disease and hold the promise of improving current outcomes seen in patients with early-stage disease.
  • [MeSH-major] Carcinoma, Small Cell / surgery. Carcinoma, Small Cell / therapy. Lung Neoplasms / surgery. Lung Neoplasms / therapy

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  • (PMID = 17447436.001).
  • [ISSN] 0890-9091
  • [Journal-full-title] Oncology (Williston Park, N.Y.)
  • [ISO-abbreviation] Oncology (Williston Park, N.Y.)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 104
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72. Hu X, Bao Y, Zhang L, Cheng Y, Li K, Wang W, Liu Y, He H, Sun Z, Zhuang T, Wang Y, Chen J, Liang Y, Zhang Y, Zhao H, Wang F, Chen M: [A prospective randomized study of the radiotherapy volume for limited-stage small cell lung cancer: a preliminary report]. Zhongguo Fei Ai Za Zhi; 2010 Jul;13(7):691-9
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  • [Title] [A prospective randomized study of the radiotherapy volume for limited-stage small cell lung cancer: a preliminary report].
  • BACKGROUND AND OBJECTIVE: Controversies exists with regard to target volumes as far as thoracic radiotherapy (TRT) is concerned in the multimodality treatment for limited-stage small cell lung cancer (LSCLC).
  • The aim of this study is to prospectively compare the local control rate, toxicity profiles, and overall survival (OS) between patients received different target volumes irradiation after induction chemotherapy.
  • METHODS: LSCLC patients received 2 cycles of etoposide and cisplatin (EP) induction chemotherapy and were randomly assigned to receive TRT to either the post- or pre-chemotherapy tumor extent (GTV-T) as study arm and control arm, CTV-N included the positive nodal drainage area for both arms.
  • One to 2 weeks after induction chemotherapy, 45 Gy/30 Fx/19 d TRT was administered concurrently with the third cycle of EP regimen.
  • Prophylactic cranial irradiation (PCI) was administered to patients with a complete response.
  • Medastinal N3 disease was the risk factor for INF (P = 0.02, OR = 14.13, 95% CI: 1.47-136.13).
  • Grade 0-I and II-III late pulmonary injury was developed in 97.1%, 2.9% and 86.4%, 15.4% patients respectively (P = 0.07).
  • Median survival time was 22.1 months and 26.9 months respectively.
  • CONCLUSIONS: The preliminary results of this study indicate that irradiant the post-chemotherapy tumor extent (GTV-T) and positive nodal drainage area did not decrease local control and overall survival while radiation toxicity was reduced.
  • [MeSH-major] Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Small Cell Lung Carcinoma / drug therapy. Small Cell Lung Carcinoma / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Drug Administration Schedule. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Follow-Up Studies. Humans. Lung Injury / etiology. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy / adverse effects. Radiotherapy / methods. Radiotherapy Dosage. Survival Analysis. Thrombocytopenia / etiology. Time Factors. Treatment Outcome. Tumor Burden / drug effects. Tumor Burden / radiation effects

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  • (PMID = 20673485.001).
  • [ISSN] 1999-6187
  • [Journal-full-title] Zhongguo fei ai za zhi = Chinese journal of lung cancer
  • [ISO-abbreviation] Zhongguo Fei Ai Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] China
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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73. Stinchcombe TE, Gore EM: Limited-stage small cell lung cancer: current chemoradiotherapy treatment paradigms. Oncologist; 2010;15(2):187-95
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  • [Title] Limited-stage small cell lung cancer: current chemoradiotherapy treatment paradigms.
  • In the U.S., the prevalence of small cell lung cancer (SCLC) is declining, probably reflecting the decreasing prevalence of tobacco use.
  • However, a significant number of patients will receive a diagnosis of SCLC, and approximately 40% of patients with SCLC will have limited-stage (LS) disease, which is potentially curable with the combination of chemotherapy and radiation therapy.
  • The standard therapy for LS-SCLC is concurrent chemoradiotherapy, and the 5-year survival rate observed in clinical trials is approximately 25%.
  • The standard chemotherapy remains cisplatin and etoposide, but carboplatin is frequently used in patients who cannot tolerate or have a contraindication to cisplatin.
  • Substantial improvements in survival have been made through improvements in radiation therapy.
  • Concurrent chemoradiotherapy is the preferred therapy for patients who are appropriate candidates.
  • The optimal radiation schedule and dose remain topics of debate, but 1.5 Gy twice daily to a total of 45 Gy and 1.8-2.0 Gy daily to a total dose of 60-70 Gy are commonly used treatments.
  • The ongoing Radiation Therapy Oncology Group and Cancer and Leukemia Group B and the European and Canadian phase III trials will investigate different radiation treatment paradigms for patients with LS-SCLC, and completion of these trials is critical.
  • [MeSH-major] Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Small Cell Lung Carcinoma / drug therapy. Small Cell Lung Carcinoma / radiotherapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Neoplasm Staging. Survival Rate. Treatment Outcome

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  • (PMID = 20145192.001).
  • [ISSN] 1549-490X
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 74
  • [Other-IDs] NLM/ PMC3227940
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74. Gaspar LE, Gay EG, Crawford J, Putnam JB, Herbst RS, Bonner JA: Limited-stage small-cell lung cancer (stages I-III): observations from the National Cancer Data Base. Clin Lung Cancer; 2005 May;6(6):355-60
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  • [Title] Limited-stage small-cell lung cancer (stages I-III): observations from the National Cancer Data Base.
  • The standard treatment of limited-stage small-cell lung cancer (LS-SCLC) has changed over the past 15 years.
  • Standard treatment for LS-SCLC currently involves multiple-agent chemotherapy and early concurrent thoracic radiation therapy.
  • Four patient cohorts (total number of patients, 22,969) diagnosed with LS-SCLC in 1985 (N=2123), 1990 (N=6279), 1995 (N=7815), and 2000 (N=6752) were studied in order to describe demographic and treatment pattern changes as well as 5-year survival rates across cohorts.
  • The proportion of patients aged >or=70 years also significantly increased over time, from 31.6% in 1985 to 44.9% in 2000 (P<0.001).
  • Over these years, the use of chemoradiation as the primary treatment for patients with LS-SCLC increased from 34.6% to 51.9% (from 37% to 60.5% for patients aged <70 years, and from 29.5% to 41.3% for patients aged >or=70 years).
  • During the same time, the use of chemotherapy as the sole treatment decreased from 30.7% in 1985 to 21.7% in 2000.
  • Chemotherapy as the sole treatment was used in 25.9% of the population>or=70 years of age in 2000, compared with 18.3% in patients aged <70 years.
  • The percent of patients for which there was no treatment given did not change significantly between the cohorts (14.3% in 1985 and 13.7% in 2000; P<0.001).
  • The 5-year survival rates and 95% confidence intervals (CIs) for the 1985, 1990, and 1995 cohorts of all ages of patients treated with chemoradiation therapy are as follows: 10.5% (CI, 6.75%-14.25%), 11.88% (CI, 9.63%-14.13%), and 13.3% (CI, 11.2%-15.4%).
  • Between 1985 and 2000 there was a significant increase in the percentage of women diagnosed with LS-SCLC.
  • The use of combined chemotherapy and radiation therapy also increased during this period.
  • This increase in chemoradiation therapy was associated with a decreased use of chemotherapy alone.
  • Despite changes in demographics and treatment during these time intervals, the 5-year survival for patients with LS-SCLC treated with chemoradiation therapy did not increase significantly.
  • These results demonstrate the continued need for the evaluation of new treatments in this group of patients.
  • [MeSH-major] Carcinoma, Small Cell / mortality. Carcinoma, Small Cell / therapy. Lung Neoplasms / mortality. Lung Neoplasms / therapy
  • [MeSH-minor] Age Distribution. Aged. Chemotherapy, Adjuvant. Cohort Studies. Databases as Topic. Female. Humans. Male. Radiotherapy, Adjuvant. Sex Distribution. United States / epidemiology

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  • (PMID = 15943896.001).
  • [ISSN] 1525-7304
  • [Journal-full-title] Clinical lung cancer
  • [ISO-abbreviation] Clin Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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75. Curran WJ Jr: Combined-modality therapy for limited-stage small cell lung cancer. Semin Oncol; 2001 Apr;28(2 Suppl 4):14-22
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  • [Title] Combined-modality therapy for limited-stage small cell lung cancer.
  • While the International Union Against Cancer system can be used in staging small cell lung cancer (SCLC) patients, the staging distinction of "extensive stage" versus "limited stage" is commonly used.
  • This system defines limited stage as the ability to encompass all known disease within a "reasonable" radiation field.
  • The standard management of limited-stage SCLC is concurrent platinum-based chemotherapy with thoracic radiotherapy (RT).
  • Total RT doses range from 40 to 55 gy in most trials.
  • Most current clinical protocols for limited-stage SCLC use the "involved field" technique of thoracic RT, in which the RT target volume includes the known extent of primary tumor and lymph node involvement and one additional nodal station.
  • [MeSH-major] Carcinoma, Small Cell / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Cranial Irradiation. Humans. Neoplasm Staging. Radiotherapy Dosage

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  • [Copyright] Copyright 2001 by W.B. Saunders Company.
  • (PMID = 11479892.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 65
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76. Videtic GM, Stitt LW, Ash RB, Truong PT, Dar AR, Yu EW, Whiston F: Impaired diffusion capacity predicts for decreased treatment tolerance and survival in limited stage small cell lung cancer patients treated with concurrent chemoradiation. Lung Cancer; 2004 Feb;43(2):159-66
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  • [Title] Impaired diffusion capacity predicts for decreased treatment tolerance and survival in limited stage small cell lung cancer patients treated with concurrent chemoradiation.
  • PURPOSE: To determine if stratification of limited stage small cell lung cancer (LSCLC) patients by pre-treatment pulmonary function test (PFT) prognostic indicators predicts for treatment-related toxicity risks and survival following concurrent chemoradiation.
  • RT dose was: 40 Gy/15 fractions/3 weeks or 50 Gy/25 fractions/5 weeks.
  • RT fields encompassed gross and suspected microscopic disease with a 2 cm margin.
  • Pre-treatment PFT values analyzed included forced expiratory volume in 1s (FEV1) (in liter and as % predicted) and diffusion capacity for carbon monoxide (DLCO) (as % predicted).
  • Patient outcomes were analyzed for associations between recognized PFT cut-offs (FEV1 <2l, > or =2l; FEV1 <60%, > or =60% predicted; DLCO <60%, > or =60% predicted), toxicity rates, and survival.
  • Fifty-six patients (26%) required treatment breaks due to toxicity.
  • Two thirds of FEV1s measured were <2l.
  • On statistical analysis, the incidence of toxicity-related interruptions was significant for DLCO<60% (P=0.043), suggestive for FEV1<2l (P=0.1) and non-significant for FEV1<60%.
  • Patients with simultaneous DLCO<60% and FEV1<2l showed a trend toward increase toxicity risk (P=0.1).
  • For selected PFT measures, median overall survivals were: 12.7 months versus 14.8 months for DLCO<60% versus > or =60%; 13.4 months versus 17.7 months for FEV1<2l versus > or =2l; 15.4 months versus 19.9 months for DLCO<60% + FEV1<2l versus DLCO> or =60% + FEV1> or =2l.
  • Patients with both a treatment break and a DLCO<60% had the poorest median survival of all patient subsets, at 11.4 months (P=0.09).
  • <60%) is a novel predictor of increased treatment-related toxicity leading to interruptions.
  • Patients with impaired DLCOs experiencing treatment interruptions have the poorest survival.
  • Assessment of pre-treatment PFTs contributes to determining optimal management strategies for LSCLC patients receiving definitive chemoradiation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Radiation Injuries / etiology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Algorithms. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Predictive Value of Tests. Prognosis. Retrospective Studies. Risk Factors. Spirometry. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 14739036.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; CAV protocol; VP-P protocol
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77. Schild SE, Bonner JA, Shanahan TG, Brooks BJ, Marks RS, Geyer SM, Hillman SL, Farr GH Jr, Tazelaar HD, Krook JE, Geoffroy FJ, Salim M, Arusell RM, Mailliard JA, Schaefer PL, Jett JR: Long-term results of a phase III trial comparing once-daily radiotherapy with twice-daily radiotherapy in limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys; 2004 Jul 15;59(4):943-51
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  • [Title] Long-term results of a phase III trial comparing once-daily radiotherapy with twice-daily radiotherapy in limited-stage small-cell lung cancer.
  • ) RT for patients with limited-stage small-cell lung cancer (LD-SCLC).
  • METHODS AND MATERIALS: A total of 310 patients with LD-SCLC initially received three cycles of etoposide and cisplatin.
  • RT (50.4 Gy in 28 fractions) or split-course b.i.d.
  • RT (24 Gy in 16 fractions, a 2.5-week break, and 24 Gy in 16 fractions) to the chest.
  • No statistically significant differences were found in the rates of progression (p = 0.68), intrathoracic failure (p = 0.45), in-field failure (p = 0.62), or distant failure (p = 0.82) between the two treatment arms.
  • RT, the long-term survival was favorable, likely reflecting the positive influences of concurrent combined modality therapy and prophylactic cranial RT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Dose Fractionation. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Radiotherapy / adverse effects. Survival Analysis

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2004 Jul 15;59(4):925-7 [15234025.001]
  • (PMID = 15234027.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 15083; United States / NCI NIH HHS / CA / CA 25224; United States / NCI NIH HHS / CA / CA 35101; United States / NCI NIH HHS / CA / CA 35103; United States / NCI NIH HHS / CA / CA 35113; United States / NCI NIH HHS / CA / CA 35195; United States / NCI NIH HHS / CA / CA 35269; United States / NCI NIH HHS / CA / CA 35272; United States / NCI NIH HHS / CA / CA 35415; United States / NCI NIH HHS / CA / CA 35448; United States / NCI NIH HHS / CA / CA 37404; United States / NCI NIH HHS / CA / CA 37417; United States / NCI NIH HHS / CA / CA 52352; United States / NCI NIH HHS / CA / CA 60276; United States / NCI NIH HHS / CA / CA 63826; United States / NCI NIH HHS / CA / CA 63848; United States / NCI NIH HHS / CA / CA 63849
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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78. Alshehadat S, Sahmoun AE: Prophylactic cranial irradiation in limited-stage small-cell lung cancer: a retrospective analysis. Clin Adv Hematol Oncol; 2004 Jun;2(6):397-400
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  • [Title] Prophylactic cranial irradiation in limited-stage small-cell lung cancer: a retrospective analysis.
  • OBJECTIVE: It is well established that prophylactic cranial irradiation (PCI) decreases significantly the incidence of brain metastases (BM) and increases overall survival in limited-stage small-cell lung cancer (LS-SCLC) patients with complete response to induction therapy.
  • The aim of this study was to complete a review analysis of PCI use among patients diagnosed with LS-SCLC in a community hospital.
  • METHOD: A retrospective review of medical charts of patients diagnosed with LS-SCLC between January 1997 and December 2002 at a local community hospital in Fargo, North Dakota, was done to determine which of these patients subsequently received PCI.
  • Data on patient's age, gender, body mass index at diagnosis, SCLC anatomical site, other comorbidies at diagnosis, treatment of SCLC, chemotherapeutic agents used at diagnosis of SCLC, response to induction treatment, PCI use, reason(s) for no PCI, BM status, BM site, metastases to other sites, and survival were abstracted.
  • RESULTS: A total of 32 patients with LS-SCLC were identified.
  • Twenty-three (71.9%) of the patients received concurrent chemotherapy and radiation therapy.
  • Of the remaining 9 (28.1%) patients, 6 (18.7%) did not receive any treatment because of poor performance status, and 3 (9.4%) received only chemotherapy because of coexisting comorbidity.
  • Of those who had PCI, only 1 (25%) patient developed BM 35 months later.
  • We concluded that oncologists should be more willing to offer this procedure.
  • [MeSH-major] Brain Neoplasms / prevention & control. Carcinoma, Small Cell / prevention & control. Cranial Irradiation. Lung Neoplasms / pathology
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Female. Hospitals, Community / statistics & numerical data. Humans. Male. Middle Aged. North Dakota / epidemiology. Paclitaxel / administration & dosage. Prognosis. Remission Induction. Retrospective Studies. Treatment Outcome. Treatment Refusal

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  • (PMID = 16163213.001).
  • [ISSN] 1543-0790
  • [Journal-full-title] Clinical advances in hematology & oncology : H&O
  • [ISO-abbreviation] Clin Adv Hematol Oncol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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79. Ludbrook JJ, Truong PT, MacNeil MV, Lesperance M, Webber A, Joe H, Martins H, Lim J: Do age and comorbidity impact treatment allocation and outcomes in limited stage small-cell lung cancer? a community-based population analysis. Int J Radiat Oncol Biol Phys; 2003 Apr 1;55(5):1321-30
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  • [Title] Do age and comorbidity impact treatment allocation and outcomes in limited stage small-cell lung cancer? a community-based population analysis.
  • PURPOSE: The effects of age and comorbidity on treatment and outcomes for patients with limited stage small-cell lung cancer (L-SCLC) are unclear.
  • This study analyzes relapse and survival in a community-based population with L-SCLC according to age and comorbidity.
  • METHODS: A retrospective review was performed on 174 patients with L-SCLC referred to the British Columbia Cancer Agency, Vancouver Island Centre, between January 1991 and December 1999.
  • Patient and treatment characteristics, disease response, relapse, and survival were compared among three age cohorts: <65 years (n = 55, 32%), 65-74 years (n = 76, 44%), and > or =75 years (n = 43, 25%); and according to Charlson comorbidity scores 0, 1, and > or =2.
  • Multivariate analysis was performed to identify independent prognostic factors associated with treatment response and survival.
  • Combined modality chemoradiotherapy (CRT) was given in 86%, 66%, and 40% of patients ages <65, 65-74, and > or =75 years, respectively, (p <0.0001).
  • Thoracic irradiation use was comparable among the age cohorts (p >0.05), but chemotherapy use varied significantly with less intensive regimens, fewer cycles, and lower total doses with advancing age (p <0.05).
  • Overall response rates to primary treatment significantly decreased with advancing age: 91%, 79%, and 74% in patients ages <65, 65-74, and > or =75 years, respectively (p = 0.014).
  • Treatment toxicity and relapse patterns were similar across the age cohorts.
  • Overall 2-year survival rates were significantly lower with advancing age: 37%, 22%, and 19% (p = 0.003), with corresponding median survivals of 17, 12, and 7 months among patients ages <65, 65-74, and > or =75 years, respectively.
  • On multivariate analysis, age and Charlson comorbidity scores were not significantly associated with treatment response and survival.
  • Independent prognostic factors favorably associated with survival were good performance status, normal lactate dehydrogenase, absence of pleural effusion, and > or =four cycles of chemotherapy.
  • Older patients with L-SCLC were less likely to be treated with CRT, intensive chemotherapy, and PCI.
  • Treatment response and survival rates were lower with advancing age, but this may be attributed to poor performance status and suboptimal treatment rather than age.
  • [MeSH-major] Carcinoma, Small Cell / epidemiology. Lung Neoplasms / epidemiology. Patient Selection
  • [MeSH-minor] Age Factors. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. British Columbia / epidemiology. Cisplatin / administration & dosage. Cohort Studies. Combined Modality Therapy. Comorbidity. Cranial Irradiation. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Life Tables. Male. Middle Aged. Palliative Care. Prognosis. Protons / therapeutic use. Radiotherapy, High-Energy. Retrospective Studies. Risk Factors. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2003 Apr 1;55(5):1166-8 [12654422.001]
  • (PMID = 12654444.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Protons; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; CAV protocol; VP-P protocol
  • [Number-of-references] 31
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80. Myers JN, O'neil KM, Walsh TE, Hoffmeister KJ, Venzon DJ, Johnson BE: The pulmonary status of patients with limited-stage small cell lung cancer 15 years after treatment with chemotherapy and chest irradiation. Chest; 2005 Nov;128(5):3261-8
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  • [Title] The pulmonary status of patients with limited-stage small cell lung cancer 15 years after treatment with chemotherapy and chest irradiation.
  • STUDY OBJECTIVES: To describe pulmonary symptoms, signs, pulmonary function, and lung imaging studies in patients with limited-stage small cell lung cancer (SCLC) 2 to 15 years after receiving treatment with chemotherapy and chest radiotherapy.
  • PATIENTS: One hundred fifty-six patients with SCLC who were enrolled between 1974 and 1994.
  • INTERVENTIONS: Patients with limited-stage SCLC treated on prospective therapeutic studies of combined chemotherapy and radiation therapy were identified.
  • Pulmonary symptoms, physical findings, pulmonary function tests, arterial blood gas measurements, and chest imaging studies were assessed at baseline, and at 1 to 2 years, at 3 to 5 years, and at > 5 years following the initiation of treatment.
  • Pulmonary function test results showed no significant changes in percent predicted values for FVC, FEV(1), and FEV(1)/FVC ratio over the time periods reviewed.
  • The percent predicted values for the diffusing capacity of the lung for carbon monoxide decreased from 71% before the start of treatment to 56% (p < 0.032) at 1 to 2 years.
  • Values improved in most patients beyond 5 years after starting treatment.
  • CONCLUSIONS: Long-term survivors with limited-stage SCLC who were treated with combined chemotherapy and chest radiotherapy have minimal changes in pulmonary symptoms or function from 5 to 15 years after the start of treatment.
  • A concern for late toxicity from combined-modality therapy should not dissuade clinicians from offering therapy with potentially curative result with minimal to no pulmonary dysfunction.
  • [MeSH-major] Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy

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  • (PMID = 16304271.001).
  • [ISSN] 0012-3692
  • [Journal-full-title] Chest
  • [ISO-abbreviation] Chest
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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81. Arquette M, Wasserman T, Govindan R, Garfield D, Senzer N, Gillenwater H, Socinski M: Phase II evaluation of amifostine as an esophageal mucosal protectant in the treatment of limited-stage small cell lung cancer with chemotherapy and twice-daily radiation. Semin Radiat Oncol; 2002 Jan;12(1 Suppl 1):59-61
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  • [Title] Phase II evaluation of amifostine as an esophageal mucosal protectant in the treatment of limited-stage small cell lung cancer with chemotherapy and twice-daily radiation.
  • For limited-stage small cell lung cancer, twice-daily radiation with concurrent chemotherapy improves survival rate, but has dose-limiting esophageal toxicity.
  • These results differ from the use of amifostine in non-small cell lung cancer in which there is the observation of esophageal protection.
  • [MeSH-major] Amifostine / therapeutic use. Antineoplastic Agents / therapeutic use. Carcinoma, Small Cell / radiotherapy. Esophagus / radiation effects. Lung Neoplasms / radiotherapy. Radiation-Protective Agents / therapeutic use
  • [MeSH-minor] Combined Modality Therapy. Dose-Response Relationship, Radiation. Esophagitis / pathology. Esophagitis / prevention & control. Humans. Radiation Injuries / prevention & control

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  • [Copyright] Copyright 2002, Elsevier Science (USA). All rights reserved.
  • (PMID = 11917286.001).
  • [ISSN] 1053-4296
  • [Journal-full-title] Seminars in radiation oncology
  • [ISO-abbreviation] Semin Radiat Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiation-Protective Agents; M487QF2F4V / Amifostine
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82. Tas F, Aydiner A, Demir C, Topuz E: Serum lactate dehydrogenase levels at presentation predict outcome of patients with limited-stage small-cell lung cancer. Am J Clin Oncol; 2001 Aug;24(4):376-8
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  • [Title] Serum lactate dehydrogenase levels at presentation predict outcome of patients with limited-stage small-cell lung cancer.
  • Serum lactate dehydrogenase (LDH) is a biochemical parameter that is elevated in the majority of extensive-stage small-cell lung cancer (SCLC).
  • In this study, distribution and prognostic importance of serum LDH in limited-disease SCLC were investigated.
  • Significant positive association was found between LDH levels and weight loss, performance status, response to chemotherapy, and albumin but not between age, gender, and hemoglobin values.
  • At the time of diagnosis, serum levels of LDH appear to have a significant relation to outcome in patients with limited-stage SCLC.
  • [MeSH-major] Carcinoma, Small Cell / blood. L-Lactate Dehydrogenase / blood. Lung Neoplasms / blood

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  • (PMID = 11474266.001).
  • [ISSN] 0277-3732
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers; EC 1.1.1.27 / L-Lactate Dehydrogenase
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83. Socinski MA, Bogart JA: Limited-stage small-cell lung cancer: the current status of combined-modality therapy. J Clin Oncol; 2007 Sep 10;25(26):4137-45
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  • [Title] Limited-stage small-cell lung cancer: the current status of combined-modality therapy.
  • Limited-stage (LS) small-cell lung cancer (SCLC) remains a therapeutic challenge to medical and radiation oncologists.
  • The treatment of LS-SCLC has evolved significantly over the last two decades with combined-modality therapy now the standard of care.
  • The addition of thoracic radiotherapy (TRT) to standard chemotherapy has led to improvements in long-term survival in this population.
  • In a landmark trial, twice-daily TRT to a dose of 45 Gy increased 5-year survival by 10% compared with once-daily TRT administered to the same dose.
  • Strategies currently under investigation include higher total daily doses delivered once daily or novel concurrent boost techniques allowing more intensive treatments over shorter periods of time.
  • Several trials and meta-analyses have evaluated the timing of TRT with chemotherapy, with the weight of evidence suggesting that early and concurrent TRT with chemotherapy is optimal.
  • Novel cytotoxic chemotherapy combinations have failed thus far to provide an advantage over standard etoposide-cisplatin combinations.
  • LS-SCLC has been a model cancer in terms of the potential benefit of combined chemoradiotherapy strategies in improving patient outcomes.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Animals. Combined Modality Therapy. Humans. Neoplasm Staging

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  • (PMID = 17827464.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 91
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84. Ziske C, Gorschlüter M, Mey U, Offergeld R, Glasmacher A, Schmidt-Wolf IG: Sequential high-dose chemotherapy with autologous stem cell support in patients with limited-stage small cell lung cancer. Anticancer Res; 2002 Nov-Dec;22(6B):3723-6
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  • [Title] Sequential high-dose chemotherapy with autologous stem cell support in patients with limited-stage small cell lung cancer.
  • To determine the feasibility and safety of multiple sequential courses of high-dose chemotherapy with peripheral blood progenitor cells (PBSCs) followed by thoracic irradiation (54 Gy) and prophylactic cranial irradiation (PCI 30 Gy) in patients with limited disease (LD) small cell lung cancer (SCLC), six patients received one cycle of conventional-dose chemotherapy followed by four cycles of high-dose chemotherapy with stem cell support.
  • Neither significant adverse side-effects nor treatment mortality were observed.
  • According to our data we stopped this chemotherapy regime because it was not able to prevent cerebral disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Lung Neoplasms / drug therapy. Peripheral Blood Stem Cell Transplantation
  • [MeSH-minor] Adult. Brain Neoplasms / prevention & control. Brain Neoplasms / secondary. Carboplatin / administration & dosage. Carboplatin / adverse effects. Combined Modality Therapy. Cranial Irradiation. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Dose-Response Relationship, Drug. Epirubicin / administration & dosage. Epirubicin / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Granulocyte Colony-Stimulating Factor / administration & dosage. Hematopoietic Stem Cell Mobilization. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Male. Middle Aged. Neoplasm Staging

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  • (PMID = 12552983.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor; 3Z8479ZZ5X / Epirubicin; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; UM20QQM95Y / Ifosfamide
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85. Sas-Korczyńska B, Korzeniowski S, Wójcik E: Comparison of the effectiveness of "late" and "early" prophylactic cranial irradiation in patients with limited-stage small cell lung cancer. Strahlenther Onkol; 2010 Jun;186(6):315-9
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  • [Title] Comparison of the effectiveness of "late" and "early" prophylactic cranial irradiation in patients with limited-stage small cell lung cancer.
  • PURPOSE: To evaluate the effectiveness of timing of application of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer in limited stage of disease (LS SCLC).
  • PATIENTS AND METHODS: Between 1995 and 2004, 129 patients with LS SCLC were treated within two consecutive phase II studies assessing different schedules of combined treatment.
  • All patients received chemotherapy and concurrent thoracic radiotherapy.
  • In 86 patients (66.7%) who developed complete response in the thorax, PCI was performed either after chemoradiotherapy ("late" PCI , n = 45 [52.4%]) or during chemoradiotherapy ("early" PCI, n = 41 [47.7%]).
  • In the latter case, PCI was given immediately after the end of thoracic radiotherapy and prior to the last cycles of chemotherapy to a total dose of 30 Gy in 2-Gy fractions to the whole brain.
  • The results were evaluated with regard to 4-year rates of overall survival, disease-free survival, and brain metastases-free survival.
  • Additionally, the prognostic role of PCI application and its time delay in relation to survival rates and incidence of brain metastases was estimated.
  • RESULTS: The 4-year survival rates were 25.5% for overall survival, 26.8% for disease-free survival, and 67.8% for brain metastases-free survival.
  • During the observation period, 32 patients (24.8%) developed brain metastases, which occurred in 20 of 43 patients (46.5%) without and only in twelve out of 86 patients (14%) with PCI.
  • The 4-year brain metastases-free survival rates were 81.8%, if PCI was applied, versus 32.2%, if no such procedure was used (for p = 0.0000).
  • CONCLUSION: PCI significantly decreases the incidence of brain metastases and delays their development in patients with LS SCLC.
  • "Early" PCI is more effective than PCI applied after combined therapy.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Brain Neoplasms / secondary. Carcinoma, Small Cell / radiotherapy. Carcinoma, Small Cell / secondary. Cranial Irradiation. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Dose Fractionation. Female. Humans. Male. Middle Aged. Neoplasm Staging. Treatment Outcome

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  • (PMID = 20495970.001).
  • [ISSN] 1439-099X
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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86. Erridge SC, Murray N: Thoracic radiotherapy for limited-stage small cell lung cancer: issues of timing, volumes, dose, and fractionation. Semin Oncol; 2003 Feb;30(1):26-37
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  • [Title] Thoracic radiotherapy for limited-stage small cell lung cancer: issues of timing, volumes, dose, and fractionation.
  • Although meta-analysis of randomized trials comparing chemotherapy alone versus chemotherapy plus thoracic irradiation demonstrated that thoracic radiotherapy reduced mortality by 14%, this analysis probably underestimates the effect of optimally delivered thoracic irradiation integrated with appropriate chemotherapy.
  • Theoretically, early use of radiotherapy should reduce the probability of chemotherapy and radiation resistance, accelerated repopulation, and metastatic events.
  • The "chemoradiation package" can be defined as the time from the start of chemotherapy until the completion of radiotherapy.
  • The best median survival and long-term survival rates have been observed in trials with a chemoradiation package time of less than 6 weeks.
  • Protocols combining chemotherapy and radiotherapy must respect radiobiologic principles concerning the time factor derived from radiotherapy fractionation studies.
  • [MeSH-major] Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Dose Fractionation. Humans. Radiotherapy Dosage. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic

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  • [Copyright] Copyright 2003, Elsevier Science (USA). All rights reserved.
  • (PMID = 12635087.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 62
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87. Turrisi AT 3rd: Limited stage small cell lung cancer: treatment and therapy. Curr Treat Options Oncol; 2003 Feb;4(1):61-4
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  • [Title] Limited stage small cell lung cancer: treatment and therapy.
  • Chemotherapy remains the key treatment for small cell lung cancer; today, that chemotherapy remains cisplatin and etoposide in a variety of acceptable schedules.
  • Attempts to use new drugs in extensive disease have not been as successful as hoped; however, a recent trial from Japan supports the use of irinotecan and cisplatin over the standard cisplatin and etoposide, but these facts need to be verified in western countries.
  • For limited disease, the addition of thoracic radiotherapy for all patients and prophylactic cranial irradiation (PCI) in complete, or near complete, responders have resulted in improved survival.
  • The best results occur with early, intensive thoracic radiotherapy concurrent with chemotherapy and PCI after completion of systemic and local therapy.
  • The use of PCI and thoracic radiotherapy in extensive disease is more controversial and less evidence based.
  • The role of surgery is of limited value in the unusual cases of mediastinal negative disease, but it is a good treatment for patients with peripheral nodules and sufficient pulmonary function to withstand thoracotomy.
  • [MeSH-major] Camptothecin / analogs & derivatives. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Etoposide / administration & dosage. Humans. Prognosis. Treatment Outcome

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  • (PMID = 12525280.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0H43101T0J / irinotecan; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
  • [Number-of-references] 12
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88. Watkins JM, Fortney JA, Wahlquist AE, Shirai K, Garrett-Mayer E, Aguero EG, Sherman CA, Turrisi AT 3rd, Sharma AK: Once-daily radiotherapy to > or =59.4 Gy versus twice-daily radiotherapy to > or =45.0 Gy with concurrent chemotherapy for limited-stage small-cell lung cancer: a comparative analysis of toxicities and outcomes. Jpn J Radiol; 2010 Jun;28(5):340-8
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  • [Title] Once-daily radiotherapy to > or =59.4 Gy versus twice-daily radiotherapy to > or =45.0 Gy with concurrent chemotherapy for limited-stage small-cell lung cancer: a comparative analysis of toxicities and outcomes.
  • PURPOSE: The aim of this study was to compare toxicities, disease control, survival outcomes, and patterns of failure between groups of limited-stage small-cell lung cancer patients treated with once-daily versus twice-daily radiotherapy and concurrent chemotherapy.
  • MATERIALS AND METHODS: This single-institution retrospective analysis included a comparison of two of radiotherapy regimens to planned doses of (1) > or =59.4 Gy at 1.8-2.0 Gy per once-daily fraction or (2) > or =45 Gy at 1.5 Gy per twice-daily fractions with concurrent platinum-based chemotherapy.
  • Comparative analyses of toxicities and disease control were performed.
  • Patient, tumor, staging, and treatment factors were similar between the two treatment groups.
  • Median planned radiotherapy doses were 60 Gy (range 59.4-70.0 Gy) and 45 Gy (range 45-51 Gy) for the once-daily and twice-daily groups, respectively.
  • CONCLUSION: The present analysis did not detect a statistically significant difference in acute toxicities, disease control, or survival outcomes in limited-stage small-cell lung cancer patients treated with concurrent chemotherapy and once-daily versus twice-daily radiotherapy.
  • [MeSH-major] Lung Neoplasms / therapy. Radiotherapy Dosage. Small Cell Lung Carcinoma / therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Radiotherapy / adverse effects. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 20585921.001).
  • [ISSN] 1867-108X
  • [Journal-full-title] Japanese journal of radiology
  • [ISO-abbreviation] Jpn J Radiol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] Japan
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89. Horn L, Bernardo P, Sandler A, Wagner H, Levitan N, Levitt ML, Johnson DH: A phase II study of paclitaxel + etoposide + cisplatin + concurrent radiation therapy for previously untreated limited stage small cell lung cancer (E2596): a trial of the Eastern Cooperative Oncology Group. J Thorac Oncol; 2009 Apr;4(4):527-33
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  • [Title] A phase II study of paclitaxel + etoposide + cisplatin + concurrent radiation therapy for previously untreated limited stage small cell lung cancer (E2596): a trial of the Eastern Cooperative Oncology Group.
  • INTRODUCTION: To determine the 1-year survival, response rate, and toxicity for patients with limited stage small cell lung cancer treated with the combination of cisplatin plus etoposide plus paclitaxel with delayed concurrent (starting with cycle 3) high dose thoracic radiotherapy.
  • PATIENTS AND METHODS: Patients with previously untreated limited stage small cell lung cancer, Easter Cooperative Oncology Group performance status of 0-2 and adequate organ function were eligible.
  • Cycles 1 and 2 of chemotherapy consisted of paclitaxel 170 mg/m intravenous day 1, etoposide 80 mg/m intravenous days 1 to 3, and cisplatin 60 mg/m intravenous day 1 followed by filgrastim 5 microg/kg subcutaneously days 4 to 13.
  • Cycles 3 and 4 of chemotherapy consisted of a reduced dose of paclitaxel 135 mg/m intravenous day 1, and the same dose of etoposide and cisplatin with concurrent thoracic radiation therapy 1.8 Gy in 35 fractions (total 63 Gy) administered over 7 weeks.
  • CONCLUSIONS: The combination of cisplatin plus etoposide plus paclitaxel chemotherapy and concurrent delayed thoracic radiotherapy as administered in this trial provide no apparent advantage with respect to response, local control, or survival compared with historical controls.

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  • (PMID = 19240650.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA14548; United States / NCI NIH HHS / CA / CA090625-09; United States / NCI NIH HHS / CA / K12 CA090625; United States / NCI NIH HHS / CA / CA66636; United States / NCI NIH HHS / CA / U10 CA021115; United States / NCI NIH HHS / CA / U10 CA066636; United States / NCI NIH HHS / CA / CA49957; United States / NCI NIH HHS / CA / U10 CA014548; United States / NCI NIH HHS / CA / U10 CA023318; United States / NCI NIH HHS / CA / K12 CA090625-09; United States / NCI NIH HHS / CA / U10 CA049957; United States / NCI NIH HHS / CA / CA21115; United States / NCI NIH HHS / CA / CA23318
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ NIHMS311605; NLM/ PMC3528175
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90. Leonardo JM, Moran JF, Bullock L, Sarma K, Nguyen NP, Hudimac E, Kerlin K, Reilly J, Philippart C: Induction chemotherapy using paclitaxel and carboplatin and thoracic radiation prior to surgery for locoregionally advanced non-small cell lung cancer: Results of a phase II trial. J Clin Oncol; 2004 Jul 15;22(14_suppl):7301

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Induction chemotherapy using paclitaxel and carboplatin and thoracic radiation prior to surgery for locoregionally advanced non-small cell lung cancer: Results of a phase II trial.
  • : 7301 Background: Surgery with complete resection of disease remains the optimal treatment for non-small cell lung cancer.
  • We initiated a Phase II study to determine if patients with marginally resectable or potentially, but initially unresectable disease could be "downstaged" and eventually undergo a complete resection of their tumor by receiving preoperative chemotherapy and radiation.
  • METHODS: 32 patients with pathologically confirmed stage IIIA or IIIB NSCLC have been enrolled.
  • Patients received two cycles of chemotherapy with paclitaxel (Taxol®) and carboplatin (Paraplatin®) given at 200 mg/m<sup>2</sup> and AUC 6, respectively on days 1 and 22.
  • An additional two cycles of paclitaxel, 175 mg/m<sup>2</sup> and carboplatin, AUC=6 were given on days 43 and 64 concomitant with radiotherapy to a total dose of 4500cGy beginning on day 43.
  • Patients underwent attempted resection approximately 6 weeks following completion of chemotherapy and radiation.
  • RESULTS: 5 of the 32 patients are still undergoing treatment.
  • 23 of 27 patients have completed 4 cycles of chemotherapy and radiation.
  • Of these, 3 were found to be unresectable at the time of surgery, and 17/20 underwent complete resection.
  • 1 of the 7 patients who had a complete pathologic response died 39 months following enrollment with carcinomatous meningitis; the remaining six patients in this group are alive without evidence of disease at 10-37 months of follow-up.
  • CONCLUSIONS: Neoadjuvant chemotherapy using paclitaxel and carboplatin with a limited course of thoracic radiation may markedly improve the outcome for patients with regionally advanced NSCLC who are initially unresectable.
  • A significant number of patients who complete treatment will have a complete pathologic response.

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  • (PMID = 28015046.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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91. Le QT, McCoy J, Williamson S, Ryu J, Gaspar LE, Edelman MJ, Dakhil SR, Sides SD, Crowley JJ, Gandara DR, Southwest oncology group: Phase I study of tirapazamine plus cisplatin/etoposide and concurrent thoracic radiotherapy in limited-stage small cell lung cancer (S0004): a Southwest Oncology Group study. Clin Cancer Res; 2004 Aug 15;10(16):5418-24
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  • [Title] Phase I study of tirapazamine plus cisplatin/etoposide and concurrent thoracic radiotherapy in limited-stage small cell lung cancer (S0004): a Southwest Oncology Group study.
  • PURPOSE: To determine the feasibility and a recommended phase II dose of tirapazamine when combined with chemoradiotherapy in limited-stage small cell lung cancer (LSCLC).
  • EXPERIMENTAL DESIGN: Concurrent chemoradiotherapy consisted of two cycles of cisplatin, etoposide, and once-daily radiation to 61 Gy.
  • Consolidation therapy consisted of two cycles of tirapazamine (330 mg/m2), cisplatin, and etoposide.
  • There were two treatment-related deaths: one from neutropenic fever and one from respiratory infection.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy. Triazines / toxicity
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Esophagitis / chemically induced. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neutropenia / chemically induced. Radiation-Sensitizing Agents / toxicity. Radiotherapy Dosage. Vomiting / chemically induced

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  • (PMID = 15328179.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA04919; United States / NCI NIH HHS / CA / CA12644; United States / NCI NIH HHS / CA / CA20319; United States / NCI NIH HHS / CA / CA22433; United States / NCI NIH HHS / CA / CA32102; United States / NCI NIH HHS / CA / CA35119; United States / NCI NIH HHS / CA / CA35128; United States / NCI NIH HHS / CA / CA35261; United States / NCI NIH HHS / CA / CA35431; United States / NCI NIH HHS / CA / CA37981; United States / NCI NIH HHS / CA / CA38926; United States / NCI NIH HHS / CA / CA46441; United States / NCI NIH HHS / CA / CA52654; United States / NCI NIH HHS / CA / CA58658; United States / NCI NIH HHS / CA / CA58861; United States / NCI NIH HHS / CA / CA63845; United States / NCI NIH HHS / CA / CA67575; United States / NCI NIH HHS / CA / CA74647; United States / NCI NIH HHS / CA / CA76132
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; 0 / Triazines; 1UD32YR59G / tirapazamine; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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92. Mennecier B, Jacoulet P, Dubiez A, Westeel V, Bosset JF, Magnin V, Depierre A: Concurrent cisplatin/etoposide chemotherapy plus twice daily thoracic radiotherapy in limited stage small cell lung cancer: a phase II study. Lung Cancer; 2000 Mar;27(3):137-43
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  • [Title] Concurrent cisplatin/etoposide chemotherapy plus twice daily thoracic radiotherapy in limited stage small cell lung cancer: a phase II study.
  • Thirty-one previously untreated patients with limited stage small-cell lung cancer (LSCLC) were included in a prospective study, to investigate the feasability and the efficacy of a combined modality treatment using concurrent hyperfractionated chest irradiation and cisplatin (P) plus etoposide (E) chemotherapy.
  • Irradiated patients received 45 Gy in two daily fractions, 5 days a week, from week 4 to week 6.
  • During week 5, prophylactic cranial irradiation was initiated, in one daily fraction of 2.5 Gy for a total dose of 25 Gy.
  • The median survival time was 14 months and the 2-year survival rate was 25%.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Etoposide / administration & dosage. Female. Humans. Injections, Intravenous. Male. Middle Aged. Prospective Studies. Survival Analysis. Treatment Outcome

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  • [CommentIn] Lung Cancer. 2000 Mar;27(3):133-5 [10858068.001]
  • (PMID = 10699687.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] IRELAND
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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93. Brown PD, Bonner JA, Foote RL, Frytak S, Marks RS, Richardson RL, Creagan ET: Long-term results of a phase I/II study of high-dose thoracic radiotherapy with concomitant cisplatin and etoposide in limited stage small-cell lung cancer. Am J Clin Oncol; 2001 Dec;24(6):556-61
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  • [Title] Long-term results of a phase I/II study of high-dose thoracic radiotherapy with concomitant cisplatin and etoposide in limited stage small-cell lung cancer.
  • This report presents the results from a Mayo Clinic initiated phase I/II study exploring a potentially more aggressive local and systemic approach for treatment of limited-stage small-cell lung cancer (LSSCLC).
  • Five patients with LSSCLC received three cycles of induction cyclophosphamide, etoposide, and infusion cisplatin chemotherapy.
  • This was followed by accelerated hyperfractionated thoracic radiotherapy (AHFTRT) consisting of 30 Gy given as 1.5-Gy fractions twice daily with a 2-week break and then the AHFTRT was repeated.
  • After completion of the AHFTRT, patients received 4 cycles of oral etoposide maintenance chemotherapy.
  • No patients completed the entire protocol because of toxicity or progression during treatment.
  • There were two recurrences within the irradiated field, and distant metastases developed in four patients.
  • Acute nonlymphocytic leukemia developed in one patient, who died 2 months later.
  • No patient completed the entire protocol, because of toxicity or progression; therefore, this protocol cannot be recommended for the treatment of LSSCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Brain Neoplasms / prevention & control. Brain Neoplasms / secondary. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Cyclophosphamide / administration & dosage. Disease-Free Survival. Dose Fractionation. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged

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  • (PMID = 11801753.001).
  • [ISSN] 0277-3732
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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94. Takada M, Fukuoka M, Kawahara M, Sugiura T, Yokoyama A, Yokota S, Nishiwaki Y, Watanabe K, Noda K, Tamura T, Fukuda H, Saijo N: Phase III study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104. J Clin Oncol; 2002 Jul 15;20(14):3054-60
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  • [Title] Phase III study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104.
  • PURPOSE: To evaluate the optimal timing for thoracic radiotherapy (TRT) in limited-stage small-cell lung cancer (LS-SCLC), the Lung Cancer Study Group of the Japan Clinical Oncology Group conducted a phase III study in which patients were randomized to sequential TRT or concurrent TRT.
  • PATIENTS AND METHODS: We treated 231 patients with LS-SCLC.
  • TRT consisted of 45 Gy over 3 weeks (1.5 Gy twice daily), and the patients were randomly assigned to receive either sequential or concurrent TRT.
  • TRT was begun on day 2 of the first cycle of chemotherapy in the concurrent arm and after the fourth cycle in the sequential arm.
  • The median survival time was 19.7 months in the sequential arm versus 27.2 months in the concurrent arm.
  • CONCLUSION: This study strongly suggests that cisplatin plus etoposide and concurrent radiotherapy is more effective for the treatment of LS-SCLC than cisplatin plus etoposide and sequential radiotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant / adverse effects. Disease Progression. Disease-Free Survival. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Prospective Studies. Radiotherapy Dosage. Radiotherapy, Adjuvant / adverse effects. Risk. Survival Analysis. Treatment Outcome

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  • [CommentIn] J Clin Oncol. 2002 Jul 15;20(14):3045-7 [12118015.001]
  • (PMID = 12118018.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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95. Schild SE, Bonner JA, Hillman S, Kozelsky TF, Vigliotti AP, Marks RS, Graham DL, Soori GS, Kugler JW, Tenglin RC, Wender DB, Adjei A: Results of a phase II study of high-dose thoracic radiation therapy with concurrent cisplatin and etoposide in limited-stage small-cell lung cancer (NCCTG 95-20-53). J Clin Oncol; 2007 Jul 20;25(21):3124-9
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  • [Title] Results of a phase II study of high-dose thoracic radiation therapy with concurrent cisplatin and etoposide in limited-stage small-cell lung cancer (NCCTG 95-20-53).
  • PURPOSE: To evaluate the outcome of patients with limited-stage small-cell lung cancer (L-SCLC) treated with cisplatin and etoposide (PE), early prophylactic cranial irradiation (PCI), and high-dose twice-daily thoracic radiotherapy (bid RT).
  • PCI (25 Gy/10 fractions) was delivered during cycle 3 to responding patients.
  • Cycles 4 and 5 included concurrent chemotherapy and thoracic RT (30 Gy/20 bid fractions, a 2-week break, and another 30 Gy/20 bid fractions).
  • Only one (2%) of the 61 patients who received PCI experienced treatment failure in the brain.
  • The 5-year cumulative incidence of in-field treatment failure was 34%.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Small Cell / mortality. Carcinoma, Small Cell / therapy. Lung Neoplasms / mortality. Lung Neoplasms / therapy. Radiotherapy, High-Energy / methods
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Dose Fractionation. Dose-Response Relationship, Drug. Dose-Response Relationship, Radiation. Etoposide / administration & dosage. Female. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Prognosis. Risk Assessment. Survival Analysis. Treatment Outcome

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  • (PMID = 17634491.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-25224; United States / NCI NIH HHS / CA / CA-35101; United States / NCI NIH HHS / CA / CA-35103; United States / NCI NIH HHS / CA / CA-35113; United States / NCI NIH HHS / CA / CA-35269; United States / NCI NIH HHS / CA / CA-35272; United States / NCI NIH HHS / CA / CA-35415; United States / NCI NIH HHS / CA / CA-35448; United States / NCI NIH HHS / CA / CA-37404; United States / NCI NIH HHS / CA / CA-37417; United States / NCI NIH HHS / CA / CA-52352; United States / NCI NIH HHS / CA / CA-60276; United States / NCI NIH HHS / CA / CA-63849
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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96. Blackstock AW, Bogart JA, Matthews C, Lovato JF, McCoy T, Livengood K, Ho C, White D, Atkins JN, Miller AA: Split-course versus continuous thoracic radiation therapy for limited-stage small-cell lung cancer: final report of a randomized phase III trial. Clin Lung Cancer; 2005 Mar;6(5):287-92
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  • [Title] Split-course versus continuous thoracic radiation therapy for limited-stage small-cell lung cancer: final report of a randomized phase III trial.
  • The optimal integration of radiation and chemotherapy for limited-stage small-cell lung cancer (SCLC) remains unclear.
  • This phase III trial was conducted to determine whether chemotherapy plus interdigitating split-course thoracic radiation therapy (RT) improved survival compared with standard-dose continuous thoracic RT.
  • One hundred fourteen patients were randomized to receive 50 Gy thoracic RT delivered in 2.0-Gy fractions given continuously (5 weeks) concurrent with the first 2 cycles of chemotherapy (arm A) or 50 Gy delivered via an interdigitating split course in 2.5-Gy fractions (8 weeks) concurrent with the first 3 cycles of chemotherapy (arm B).
  • All patients received the following chemotherapy: cisplatin/etoposide on cycles 1, 2, and 5 and cyclophosphamide/vincristine/doxorubicin on cycles 3, 4, and 6.
  • Prophylactic cranial irradiation was recommended after a complete response to all therapy.
  • Grade 3/4 hematologic toxicity was common in both treatment arms.
  • Interdigitating split-course thoracic RT delivered in 2.5-Gy fractions was tolerable in patients with limited-stage SCLC but did not provide a survival advantage.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Dose Fractionation. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Survival Analysis. Vincristine / administration & dosage

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  • (PMID = 15845179.001).
  • [ISSN] 1525-7304
  • [Journal-full-title] Clinical lung cancer
  • [ISO-abbreviation] Clin Lung Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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97. Sunpaweravong P, Magree L, Rabinovitch R, Bunn P, Kelly K: A phase I/II study of docetaxel, etoposide, and carboplatin before concurrent chemoradiotherapy with cisplatin and etoposide in limited-stage small cell lung cancer. Invest New Drugs; 2006 May;24(3):213-21
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  • [Title] A phase I/II study of docetaxel, etoposide, and carboplatin before concurrent chemoradiotherapy with cisplatin and etoposide in limited-stage small cell lung cancer.
  • Limited stage small cell lung cancer (LS-SCLC) is an infrequent but aggressive tumor.
  • No major advances in the treatment of this disease have been achieved in recent years.
  • This study was conducted to determine the maximum-tolerated dose (MTD) and efficacy of docetaxel, etoposide, and carboplatin (DEC) given before definitive chest radiotherapy with concurrent cisplatin and etoposide.
  • Seventeen untreated LS-SCLC patients received docetaxel 50 mg/m2, etoposide 50-80 mg/m2, and carboplatin AUC = 5-6, intravenously on day 1 followed by etoposide 100-160 mg/m2 orally on days 2 and 3 every 21 days for two cycles followed by once daily radiotherapy to a total dose of 50 Gy given concurrently with cisplatin (60 mg/m2, d1) and etoposide (120 mg/m2, d1 and 240 mg/m2 day 2-3) for 2 cycles.
  • This novel approach produced similar efficacy results to current two drug regimens but was associated with significant neutropenia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / adverse effects. Carboplatin / administration & dosage. Carboplatin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Male. Maximum Tolerated Dose. Middle Aged. Neutropenia / chemically induced. Taxoids / administration & dosage. Taxoids / adverse effects. Treatment Outcome

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  • (PMID = 16193241.001).
  • [ISSN] 0167-6997
  • [Journal-full-title] Investigational new drugs
  • [ISO-abbreviation] Invest New Drugs
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Taxoids; 15H5577CQD / docetaxel; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin
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98. McClay EF, Bogart J, Herndon JE 2nd, Watson D, Evans L, Seagren SL, Green MR, Cancer and Leukemia Group B Study (9235): A phase III trial evaluating the combination of cisplatin, etoposide, and radiation therapy with or without tamoxifen in patients with limited-stage small cell lung cancer: Cancer and Leukemia Group B Study (9235). Am J Clin Oncol; 2005 Feb;28(1):81-90
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  • [Title] A phase III trial evaluating the combination of cisplatin, etoposide, and radiation therapy with or without tamoxifen in patients with limited-stage small cell lung cancer: Cancer and Leukemia Group B Study (9235).
  • Based on both clinical and laboratory data that suggested that tamoxifen (TAM) enhanced the effectiveness of cisplatin (DDP)-based chemotherapy regimens, the Cancer and Leukemia Group B (CALGB) designed and initiated a prospective, randomized phase III trial to test the efficacy of the addition of high-dose TAM to a standard chemoradiation regimen of DDP and etoposide (VP-16) in patients with limited-stage small cell lung cancer (LS-SCLC).
  • Between August 6, 1993, and January 15, 1999, 319 patients with LSSCLC were accrued to CALGB 9235.
  • Patients were randomized to receive chemotherapy with or without high-dose TAM.
  • Treatment on the non-TAM containing arm (arm 1) included DDP (80 mg/m2 intravenously day 1 only) and VP-16 (80 mg/m2 intravenously days 1-3) given every 3 weeks for a total of 5 cycles.
  • Patients treated on arm 2 received the identical chemotherapy regimen as described here with the addition of high-dose TAM (80 mg orally twice per day), which was given for 5 days each cycle starting 1 day before the DDP.
  • Thoracic radiation (XRT) given at 200 cGy 5 days per week to a total dose of 50 Gy began on day 1 of cycle 4 of chemotherapy and overlapped with cycle 5.
  • After the completion of the chemoradiation portion of the treatment, the overall response rate (ORR) was 88% for 154 patients treated without tamoxifen and 84% for 153 patients treated with tamoxifen with complete response (CR) rates of 49% and 50%, respectively.
  • This phase III trial failed to demonstrate a positive effect on either the response or survival for the addition of TAM to standard etoposide-cisplatin-radiation management for patients with LS-SCLC.
  • However, these data continue to support a positive effect of chemoradiation in the treatment of patients with LS-SCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Aged. Brain Neoplasms / prevention & control. Brain Neoplasms / secondary. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Cranial Irradiation. Dose Fractionation. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasms, Second Primary. Survival Analysis. Tamoxifen / administration & dosage

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  • (PMID = 15685040.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 094ZI81Y45 / Tamoxifen; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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99. Videtic GM, Truong PT, Ash RB, Yu EW, Kocha WI, Vincent MD, Tomiak AT, Dar AR, Whiston F, Stitt LW: Does sex influence the impact that smoking, treatment interruption and impaired pulmonary function have on outcomes in limited stage small cell lung cancer treatment? Can Respir J; 2005 Jul-Aug;12(5):245-50
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  • [Title] Does sex influence the impact that smoking, treatment interruption and impaired pulmonary function have on outcomes in limited stage small cell lung cancer treatment?
  • PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy.
  • METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial.
  • RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women.
  • Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M [46%]; 43 F [54%]) (continuing-to-smoke F versus M, P=0.001).
  • Fifty-six patients (26%) had radiotherapy interruptions (RTI) during chemotherapy-radiotherapy because of toxicity.
  • CONCLUSIONS: In LS-SCLC, women overall do better than men, with or without a negative variable.
  • The largest quantifiable improvement in survival for women came from smoking cessation, and for men from avoidance of breaks during treatment.
  • [MeSH-major] Carcinoma, Small Cell / mortality. Lung Neoplasms / mortality. Smoking / epidemiology


100. Garces YI, Okuno SH, Schild SE, Mandrekar SJ, Bot BM, Martens JM, Wender DB, Soori GS, Moore DF Jr, Kozelsky TF, Jett JR: Phase I North Central Cancer Treatment Group Trial-N9923 of escalating doses of twice-daily thoracic radiation therapy with amifostine and with alternating chemotherapy in limited stage small-cell lung cancer. Int J Radiat Oncol Biol Phys; 2007 Mar 15;67(4):995-1001
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  • [Title] Phase I North Central Cancer Treatment Group Trial-N9923 of escalating doses of twice-daily thoracic radiation therapy with amifostine and with alternating chemotherapy in limited stage small-cell lung cancer.
  • PURPOSE: The primary goal was to identify the maximum tolerable dose (MTD) of thoracic radiation therapy (TRT) that can be given with chemotherapy and amifostine for patients with limited-stage small-cell lung cancer (LSCLC).
  • METHODS AND MATERIALS: Treatment began with two cycles of topotecan (1 mg/m(2)) Days 1 to 5 and paclitaxel (175 mg/m(2)) Day 5 (every 3 weeks) given before and after TRT.

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  • (PMID = 17336213.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA-37404; United States / NCI NIH HHS / CA / CA-35431; United States / NCI NIH HHS / CA / CA35103; United States / NCI NIH HHS / CA / CA-52352; United States / NCI NIH HHS / CA / CA-35195; United States / NCI NIH HHS / CA / U10 CA037404; United States / NCI NIH HHS / CA / U10 CA035195; United States / NCI NIH HHS / CA / CA-25224; United States / NCI NIH HHS / CA / CA-60276; United States / NCI NIH HHS / CA / CA-35113; United States / NCI NIH HHS / CA / U10 CA035431; United States / NCI NIH HHS / CA / UG1 CA189808; United States / NCI NIH HHS / CA / CA-35101; United States / NCI NIH HHS / CA / U10 CA025224; United States / NCI NIH HHS / CA / CA-63849
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; 6PLQ3CP4P3 / Etoposide; 7M7YKX2N15 / Topotecan; M487QF2F4V / Amifostine; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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