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Maintenance chemotherapy in bronchogenic carcinoma

Taimur Sher, Grace K Dy, Alex A Adjei
Small cell lung cancer accounts for approximately 15% of bronchogenic carcinomas. It is the cancer most commonly associated with various paraneoplastic syndromes, including the syndrome of inappropriate antidiuretic hormone secretion, paraneoplastic cerebellar degeneration, and Lambert-Eaton myasthenic syndrome. Because of the high propensity of small cell lung cancer to metastasize early, surgery has a limited role as primary therapy. Although the disease is highly sensitive to chemotherapy and radiation, cure is difficult to achieve...
March 2008: Mayo Clinic Proceedings
T Bouillet, J F Morère, J J Mazeron, S Piperno-Neuman, C Boaziz, E Haddad, J L Breau
PURPOSE: To determine the efficacy and safety of induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of stage III non-small cell lung cancer and whether the response to induction chemotherapy can predict the response to subsequent chemoradiotherapy and survival. MATERIALS AND METHODS: Between December 1987 and June 1993, 46 patients with previously untreated stage III non-small cell lung cancer received every 21 days induction chemotherapy (ICT) including three cycles of 5-fluorouracil (600 mg/m2/d in short infusion from d1 to d5), cisplatin (15 mg/m2/d from d1 to d5), etoposide (50 mg/m2/d from d1 to d5) and hydroxyurea (1,500 mg/d from d1 to d5)...
1997: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
M Vogel
Intraocular metastatic tumors are rare. They are seen in 10% of patients having died of a malignant tumor. Frequently metastatic tumors of the eye are not observed clinically because the may develop in the terminal stage of the disease. The most frequent primary tumor is carcinoma of the breast with 60% of all intraocular metastatic tumors followed bronchogenic carcinoma with 19%. While breast carcinomas usually metastasize years after excision of the primary tumor, bronchogenic carcinomas may metastasize into the eye before the primary tumor reveals itself...
April 1997: Klinische Monatsblätter Für Augenheilkunde
L E Broder, K S Sridhar, O S Selawry, K N Charyulu, R K Rao, M J Saldana, E J Donnelly, W A Raub
Initially, 109 evaluable patients with locally advanced or metastatic small cell lung cancer (SCLC) were treated with vincristine, Adriamycin, procarbazine, and etoposide (VAPE). Partial (PR) or nonresponders (NR) were crossed to CCM (cyclophosphamide, CCNU, and methotrexate) and then to HMiVe (hexamethylmelamine, mitomycin C, vinblastine) sequentially at maximum response. Complete responders (CR) were intensified by 50% with VAPE primarily and randomized to VAPE, alternating with CCM or CCM alone during maintenance...
December 1994: American Journal of Clinical Oncology
C Manegold, P Drings
In the treatment of bronchogenic carcinoma approaches vary depending upon whether the carcinoma in question is defined as a small cell or a non-small cell lung cancer. Small-cell lung cancer in the majority of cases must be seen as a systemic disease even with an early diagnosis. Because of this, chemotherapy is the dominant form of treatment. For patients with limited disease radiotherapy and surgery are additionally recommended as potentially curative measures, and for those with extensive disease, surgery and radiotherapy may serve as palliative treatment...
July 22, 1995: Schweizerische Medizinische Wochenschrift
M Valdivieso, G P Bodey, R S Benjamin, H T Barkley, M B Freeman, M Ertel, T L Smith, C F Mountain
Forty-nine patients with small cell bronchogenic carcinoma (23 limited and 26 extensive disease) received their first two of three courses of intensive remission induction chemotherapy with (21 patients) or without (28 patients) intravenous hyperalimentation (IVH). The chemotherapy included six remission induction courses with ECHO (epipodophyllotoxin VP-16-213, cyclophosphamide, hydroxydaunorubicin, oncovin), followed by six courses of maintenance with PRIME (procarbazine, ifosfamide, methotrexate). Prophylactic brain irradiation (3000 r/2 weeks) was given to all patients and those with limited disease received chest irradiation (5000 r/5 weeks) at the completion of ECHO...
1981: Cancer Treatment Reports
M Valdivieso, F Cabanillas, M Keating, H T Barkley, W K Murphy, M A Burgess, H Frazier, T Chen, G P Bodey
Fifty-five patients with extensive-disease small cell bronchogenic carcinoma received three courses of intensive, inpatient, remission induction chemotherapy in (25 patients) or out (30 patients) of protected environment-prophylactic antibiotic (PEPA) units. Chemotherapy consisted of ECHO induction (E = epipodophyllotoxin VP-16-213; C = cyclophosphamide; H = hydroxydaunorubicin; O = Oncovin) and PRIME maintenance (PR = procarbazine; I = ifosfamide; ME = methotrexate). All evaluable patients (22 in the protected environment group and 26 in the control group) had a complete (50 percent in the protected environment group and 54 percent in the control group) or partial (50 percent in the protected environment group and 46 percent in the control group) remission...
March 1984: American Journal of Medicine
A Taytard, P Chomy, G Courty, J P Gachie, J Roquain
40 patients suffering from inoperable bronchial cancer (25 anaplastic cancers, 15 undifferentiated cancers) were treated by a sequential association (Adriamycinee, Vincristine, Cyclophosphamide, Méthotrexate), repeated every 5 weeks. 28 patients already had metastatic cancer. A partial objective response (regression greater than 50%) was observed in 7 undifferentiated cancers and 14 anaplastic cancers. The treatment was interrupted 3 times for digestive and/or hematological toxicity; however, no deaths due to toxicity were reported...
1980: Revue Française des Maladies Respiratoires
N Niederle, W Krischke, U Schulz, C G Schmidt, S Seeber
Since July 1978 one hundred and three consecutive patients with unresectable small cell bronchogenic carcinoma were treated with a combination of doxorubicin, cyclophosphamide and vincristine (ACO). In limited disease patients (64) the second chemotherapy course was followed by prophylactic cranial irradiation, the fourth by irradiation towards primary disease sites. Complete responders were randomised to either receive etoposide or no further maintenance therapy. Objective responses were reached in 88/100 evaluable patients, with 72% of complete remissions in limited-stage disease and 33% in extensive disease, respectively...
August 16, 1982: Klinische Wochenschrift
B A Mason, M P Richter, R B Catalano, R B Creech
Encouraging results of the combination of upper hemibody irradiation (UHBI) and local chest irradiation (LCI) combined withh standard-dose chemotherapy in patients with extensive small cell bronchogenic carcinoma led us to a second pilot study utilizing the same radiation program combined wit high-dose induction chemotherapy. Fourteen patients with small cell bronchogenic carcinoma, five with extensive disease and nine with localized disease, were treated with cyclophosphamide (1.5 g/m2 iv, Days 1 and 22), lomustine (70 mg/m2 orally, Day 1), and methotrexate (15 mg/m2 twice weekly during Weeks 2, 3, 5, and 6)...
August 1982: Cancer Treatment Reports
S Seeber, N Niederle, R B Schilcher, C G Schmidt
This report summarizes our experience in 94 patients with inoperable small cell bronchogenic carcinoma treated with protocols "ACO I" and "ACO II" at the West German Tumor Center Essen. Long-term follow-up is documented for a group of 50 patients who were fully ambulatory. Complete responses were obtained in 20 of 26 patients with "limited disease" and in 12 of 24 patients with "extensive disease". The median survival of all 50 patients was 12 months (10 months in "extensive disease", 21 months in "limited disease")...
February 1980: Onkologie
N Thatcher, P V Barber, R D Hunter, K B Carroll, S Jegarajah, P M Wilkinson, D Crowther
55 patients with inoperable but "limited"-stage small-cell carcinoma were treated sequentially with methotrexate, radiotherapy, and high doses of cyclophosphamide. The treatment was completed over 11 weeks and no maintenance chemotherapy was given. Follow-up lasted 9-29 months. Toxicity was acceptable, despite doses of cyclophosphamide of 1.5-3.5 g/m2. The complete response rate was 53%. Median survival for the total patient group was 12 months, range 2-29+. Patients who attained a complete response had a 17 month median survival; 17 patients remained in complete remission, 9 of whom first underwent treatment 14-29 months previously...
May 8, 1982: Lancet
D M Finkelstein, D S Ettinger, J C Ruckdeschel
Between December 1979 and June 1983 the Eastern Cooperative Oncology Group (ECOG) treated 893 good-performance status patients with metastatic non-small-cell lung cancer (NSCLC) on one of seven phase III combination chemotherapies. The overall median survival was 23.5 weeks with no significant differences between treatments. One hundred sixty-eight patients (19%) survived greater than 1 year and 36 (4%) for greater than 2 years. The etoposide-platinum combination had the highest proportion of 1-year survivors (25%)...
May 1986: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
M Valdivieso, C Frankmann, W K Murphy, R S Benjamin, H T Barkley, M J McMurtrey, D G Jeffries, S R Welch, G P Bodey
Sixty-five patients with small cell bronchogenic carcinoma received their first two of three courses of intensive induction chemotherapy with (30 patients) or without (35 patients) intravenous hyperalimentation (IVH). Patients predominantly had extensive disease (55%), Zubrod's performance status 0 to 2 (63%) and less than or equal to 6% pretreatment weight loss (68%). Both treatment arms were comparable by prognostic factors. The chemotherapy included six remission induction courses of ECHO chemotherapy (E: epipodophyllotoxin VP-16-213; C: cyclophosphamide; H: hydroxydaunorubicin; O: oncovin [vincristine]) followed by six courses of maintenance with PRIME (PR: procarbazine; I: ifosfamide; ME: methotrexate)...
January 15, 1987: Cancer
J K Weick, J M Rainey, R B Livingston, L H Baker, R M O'Bryan, T T Chen
Forty-five patients with stage III M1 non-small cell bronchogenic carcinoma were treated with vinblastine (1 mg/m2 by iv bolus twice a day on 2 consecutive days) plus mitomycin (10 mg/m2 on Day 1). This treatment was repeated at 3-week intervals for three courses. Consolidation therapy with doxorubicin and cisplatin at doses of 50 mg/m2 each was administered to responders every 4 weeks for two courses, with subsequent vinblastine and mitomycin maintenance therapy every 6 weeks. Eleven partial remissions (24%) were achieved, with a median duration of remission of 16 weeks (range, 8-32) and a median survival of 19 weeks...
June 1985: Cancer Treatment Reports
M J Byrne, G van Hazel, J Trotter, F Cameron, J Shepherd, B Cassidy, V Gebski
In a prospective randomised study 68 patients with limited small cell bronchogenic carcinoma were assigned to induction treatment with combined alternating non-cross-resistant chemotherapy plus split course radiotherapy without (NM) or with (M) subsequent maintenance therapy. Induction chemotherapy consisted of cisplatinum and VP16213q. 3 weeks followed by cyclophosphamide, vincristine and methotrexate (CVM)q. 4 weeks. Three courses of this 7-week chemotherapy programme were given. Radiotherapy to the primary lesion of 25 Gy in 13 fractions was given after each of the first and second courses of chemotherapy...
September 1989: British Journal of Cancer
M H Cohen, P J Creaven, B E Fossieck, L E Broder, O S Selawry, A V Johnston, C L Williams, J D Minna
Thirty-two patients (27, extensive disease; five, regional disease) with histologically documented small cell carcinoma entered a randomized study to determine the efficacy of intensive induction chemotherapy. The necessity of a protected environment (laminar air flow room) during this treatment was also evaluated. Patients received high-dose or standard-dose cyclophosphamide, methotrexate, and CCNU (CMC) during the first 6 weeks of treatment. Subsequent maintenance therapy consisted of standard-dose CMC until disease progression...
May 1977: Cancer Treatment Reports
P Alberto, K W Brunner, G Martz, J Obrecht, R W Sonntag
One hundred and eighteen patients with inoperable carcinoma of the lung were randomly selected for treatment with methotrexate, cyclophosphamide, procarbazine, and vincristine. These drugs were adminsitered simultaneously to one group of patients and sequentially to the second group. As the statistically sicame evident (51% vs. 21%), an additional 85 cases were treated in this manner without randomization. The objective clinical responses were associated with prolonged survival. A higher response rate with the simultaneous treatment was also evident in patients with anaplastic small cell carcinoma (65% vs...
December 1976: Cancer
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