COMPARISON OF INDUCTION CHEMOTHERAPY BEFORE RADIOTHERAPY WITH RADIOTHERAPY ONLY IN PATIENTS WITH LOCALLY ADVANCED SQUAMOUS-CELL CARCINOMA OF THE LUNG

The aim of this randomised trial was to investigate the effect of indu ction chemotherapy before radiotherapy on survival in 302 patients wit h non-resectable squamous cell carcinoma of the lung. Radiotherapy, 56 Gy to the chest, was given to 154 patients and combined treatment, wi th chemotherapy preceding the radiotherapy, to 148 patients. Chemother apy consisted of three courses of cisplatin (120 mg/m(2)) and etoposid e (100 mg/m(2) i.v. for 3 days) administered every fourth week. Median survival was 10.5 months in the radiotherapy arm and 11 months in the combined treatment arm. The 2-year survival rate was 17% in the radio therapy arm and 21% in the combined treatment arm. Addition of chemoth erapy seemed to significantly improve survival, according to the Cox m ultivariate analysis (P=0.04), but as only a trend according to life-t able analysis (P=0.11). Chemotherapy also accomplished a trend towards improved local control (P=0.08) and towards decreased metastatic dise ase (P=0.10). 2 patients in the combined treatment arm, but none in th e radiotherapy arm, died from toxicity. The conclusion was that the va lue of the chemotherapy used in this study was very modest, but the re sults strongly support further research for more efficient drugs and c ombinations. Copyright (C) 1996 Elsevier Science Ltd