MITOMYCIN, CISPLATIN, AND VINDESINE FOLLOWED BY RADIOTHERAPY COMBINEDWITH CISPLATIN IN STAGE-III NONSMALL CELL LUNG-CANCER - LONG-TERM RESULTS

Purpose: To assess the tolerance, response rate, pattern of failure, a nd long-term survival of patients with unresectable nonsmall cell lung cancer treated with one cycle of induction chemotherapy followed by c oncurrent cisplatin and radiotherapy. Methods and Materials: From 1986 to 1988, 45 patients with histologically proven nonsmall cell lung ca ncer clinical Stage III (29 IIIA and 16 IIIB) were included in this st udy. Patients received one cycle of Mitomycin C 10 mg/m(2) day 1, Cisp latin 120 mg/m(2) day 1, and Vindesine 3 mg/m(2) days 1, 8, 15, and 22 , by i.v. bolus injection. Radiotherapy was started within 4-6 weeks a fter completion of chemotherapy, with a total tumor dose of 60 Gy, at 2 Gy/day. Cisplatin, 20 mg/m(2)/day by i.v. continous infusion was adm inistered for days 1-5 of radiation treatment. Results: The main toxic acute effects were nausea-vomiting grade 1-3 in 38 patients (85%). Te n patients (22%) developed esophagitis grade 3. Leukopenia grade 1-2 w as observed in 18 patients (40%), grade 3 in 12 (27%), and grade 4 in 4 (9%). Three patients (6.6%) died by granulocytopenia and sepsis. A b ronchoscopic proven complete response was achieved in 9 patients (21.5 %) and partial response in 28 patients (67%). With a minimum follow-up of 65 months, overall median survival was 13 months, 2-year survival was 21%, and 5-year survival was 7%, with no statistical difference be tween Stage IIIA and IIIB. Median survival of patients with complete r esponse was 23.2 months, and 5-year survival was 33%. Conclusion: This treatment scheme produced a severe toxicity and in spite of a high re sponse rate, longterm survival is poor, similar to previous studies wi th radiotherapy alone.