ORAL ETOPOSIDE AND CARBOPLATIN - EFFECTIVE THERAPY FOR ELDERLY PATIENTS WITH SMALL-CELL LUNG-CANCER

Purpose: Elderly patients with small cell lung cancer (SCLC) and/or th ose with comorbid conditions are frequently not considered candidates for standard combination chemotherapy. An active, but less toxic regim en is needed for this group of patients. Patients and Methods. Forty-s even elderly (>65 years) or medically unfit patients with SCLC were tr eated with oral etoposide 100 mg/m(2) X 7 days and carboplatin 150 mg/ m(2) day 1. Treatment was given every 3-4 weeks for six cycles in resp onding patients. Patients responding to the chemotherapy regimen were also treated with prophylactic cranial irradiation, and limited-stage patients received thoracic radiotherapy. The study population included 36 extensive-stage patients and 11 limited-disease patients with rena l or cardiac disease that precluded standard chemotherapy. The median age of the study population was 69 years (range: 47-84). Results: Nine of 47 patients were inevaluable for response, including four patients who succumbed to sepsis. Of the 38 patients evaluable for response, 7 1% responded (95% CI: 56-86%) (88% LD; 67% ED) with a complete respons e in 29% of patients (50% LD; 23% ED). Based on an analysis of intent to treat, the overall response rate was 60% and the median survival ti me of the whole group was 46 weeks (LD, 59 weeks; ED, 45 weeks). Treat ment was generally well tolerated. Neutropenia was the dose-limiting t oxicity; the median nadir granulocyte count was 1.04 X 10(9)/L (range: 0-8.2). Conclusion. We conclude that this regimen can provide palliat ion to SCLC patients who might not otherwise be considered for systemi c chemotherapy.