A COMPARATIVE-STUDY OF CISPLATIN AND VINBLASTINE VERSUS IFOSFAMIDE, CISPLATIN AND VINBLASTINE IN NON-OPERABLE NON-SMALL-CELL LUNG-CANCER

Purpose: To evaluate the efficacy and toxicity of ifosfamide in combin ation with cisplatin and vinblastine in non-operable non-small-cell lu ng cancer (NSCLC). Methods: A total of 136 patients with stage III or IV NSCLC were randomized to either PV (cisplatin, 120 mg/m2, and vinbl astine, 6 mg/m2) or VIP (PV with the addition of ifosfamide, 3 g/m2) e very 3 weeks. Results: Patients receiving VIP had a higher response ra te (31% vs. 10%), but the performance status (PS) was significantly wo rse in those receiving PV. No difference in survival can be demonstrat ed between the two treatment groups. The median survival was 8.4 month s. In both groups, patients with stage HI disease, good PS and no visc eral involvement had better survivals. Nausea/vomiting and alopecia we re more pronounced in the VIP group, although both chemotherapies were well tolerated. Conclusions: The addition of ifosfamide improved the response rate, but a survival advantage cannot be proven. The prognost ic value of stage, PS and metastatic site is confirmed in this trial; further studies are required to select subgroups of patients who may h ave a survival benefit with combination chemotherapy. The response rat e elicited by VIP makes it a candidate for neoadjuvant treatment.