Treatment Of Small Cell Carcinoma Research Articles

Preliminary results of combined radiation and chemotherapy in the treatment of small cell carcinoma of the lung (a randomized study of cancer and leukemia group b)

Preliminary results of combined radiation and chemotherapy in the treatment of small cell carcinoma of the lung (a randomized study of cancer and leukemia group b)

Complications in the treatment of small cell carcinoma of the lung

Summary This review has shown that chemotherapy alone for small cell carcinoma of the lung is relatively safe and produces relatively few infectious and hemorrhagic complications. Combined modality therapy is also relatively safe, although it may cause a slight increase in the frequency of infectious complications. Combining radiation with doxorubicin containing chemotherapy combinations, may increase the incidence of esophagitis and stricture, radiation pneumonitis and skin toxicity if the two treatments are given concomitantly. This problem can be almost climinated if there is some reasonable separation in time between the two modalities. Cardiotoxicity does not appear to be a major problem. New methods of treatment have been discussed and their potential toxicities have been pointed out so that investigators planning to undertake studies in these new areas may attempt to avoid potential problems. Reporting toxicity is as important as response rates and survival data and therefore detailed reporting is to be encouraged.

Small cell lung carcinoma - recent advances and current challenges.

Therapeutic trials in the early and mid- 1970s led to a number of important questions in the treatment of small cell carcinoma of the lung. This paper will attempt to examine those questions in light of the outcome of subsequent studies, and to consider some concepts that are the subject of current trials.

Herpes zoster in patients with small-cell carcinoma of the lung receiving combined modality treatment.

Herpes zoster, a rare complication in patients with solid tumours, was observed in 13 of 161 (8.1%) patients with small-cell anaplastic carcinoma of the lung treated in a prospective combined modality therapy trial. Induction therapy consisted of three courses of cyclophosphamide, doxorubicin, and vincristine, followed by thoracic radiation. Maintenance chemotherapy with oral lomustine, procarbazine, and methotrexate was given for 1 year. Most herpes zoster cases (11) occurred while patients were on maintenance chemotherapy. Three patients developed nonfatal disseminated herpes zoster and one, postherpetic neuralgia. Herpes zoster may be a relatively frequent complication of prolonged aggressive treatment of small-cell carcinoma of the lung.

Lung Cancer: Progress in Therapeutic Research

Muggia and Rozenweig have done a good job of compiling a book that provides an overview of the current research effort in the treatment of lung cancer. The book is divided into nine parts that review the current research in experimental animal tumor models of lung cancer, pathological diagnosis, biologic markers, surgery, radiotherapy, chemotherapy in established disease as well as in an adjuvant setting, immunotherapy, and the therapeutic approach to small cell carcinoma. There are some exceptionally good sections in this book that should be required reading for medical oncologists; these include the chapters on experimental tumors, pathological diagnosis, Mountain's chapter on the surgical approach, and the treatment of small cell carcinoma. However, the section on biological markers was weak and of little relevance to the diagnosis, prognosis, or treatment of lung cancer. Since many of the sections were written by various authors, the style and presentation of data varies;

Radiotherapy alone or with chemotherapy in the treatment of small-cell carcinoma of the lung.

This report gives the complete findings at one year of a study comparing radiotherapy (Rt) with radiotherapy followed by 3-drug chemotherapy (RtC3) in the treatment of histologically proven small-cell carcinoma of the lung of limited extent. Over the 12-month period there was a significantly increased survival for the RtC3 patients (P = 0.002) and at 12 months 18% of the 121 Rt but 34% of the 115 RtC3 patients were alive (P = 0.009). The median survival for the Rt series was 25 weeks and for the RtC3 series 43 weeks. There was evidence of recurrence of the primary cancer in 32 (32%) of the 99 Rt and 20 (26%) of the 76 RtC3 patients who died. Distant metastases appeared earlier and were more frequent in the Rt series (P less than 0.0001) and over the 12-month period 79% of the Rt and 57% of the RtC3 patients developed distant metastases (P less than 0.0005). At 12 months only 8% of the Rt but 26% of the RtC3 patients were alive and free of metastases. Adverse reactions occurred much more frequently in the RtC3 series; 32% of the Rt series as against 83% of the RtC3 series had reactions, the most common being nausea and vomiting (13% Rt, 71% RtC3) and the most serious being marrow depression (23% Rt, 54% RtC3). No important differences were found among the survivors in the 2 series at 3, 6 or 12 months, in general condition, physical activity or respiratory function. It is concluded that radiotherapy plus chemotherapy was superior to radiotherapy alone, although chemotherapy did not protect patients from recurrence of primary growth.

Anticoagulants in the treatment of small cell carcinoma of the bronchus.

The object of this study was to see if the addition of anticoagulants to a regimen of cytotoxic drugs would improve the prognosis in patients with small cell carcinoma of the bronchus. Twenty-four patients were randomly allocated to receive chemotherapy or chemotherapy plus anticoagulants. The median survival in the group receiving the anticoagulants was not improved.

Selective surgical resection in small cell carcinoma of the lung

Surgical resection has failed notably as definitive treatment for small cell carcinoma of the lung. Newer treatment programs combining intensive chemotherapy with radiation therapy achieve a significant response in about 85 percent of cases, with about 50 percent of patients showing clinically complete remission. Long-term survival without recurrence has been the outcome in a small minority of cases. A frequent mode of failure after treatment of limited disease is recurrence within the chest. The course of one patient treated early in this series suggests that exclusion of initial surgical resection from programs of combined treatment may be a serious omission. Since that time, four patients have undergone initial resection, apparently with uniformly favorable courses to date. Selection criteria based on staging factors are proposed. Admittedly, only a minority of patients will be suitable for this treatment at the time of first diagnosis. Much opportunity exists for improvement in survival rates of patients, even those with limited disease.

Therapy of Small Cell Carcinoma of the Lung with Hexamethylmelamine

Hexamethylmelamine (HXM) is one of the substituted melamines derived from cyanuric chloride [1]. Previous studies with HXM have shown activity against small cell carcinoma of the lung, when it was given as a single agent [2, 3]. Because of relatively mild bone marrow toxicity, HXM was subsequently given in combination with other drugs and/or radiation therapy, in order to improve the therapeutic results. In this paper, our experience with HXM in treatment of small cell carcinoma of the lung is summarised.