A RANDOMIZED TRIAL OF HYBRID ADMINISTRATION OF CYCLOPHOSPHAMIDE, DOXORUBICIN, AND VINCRISTINE (CAV) CISPLATIN AND ETOPOSIDE (PVP) VERSUS SEQUENTIAL ADMINISTRATION OF CAV-PVP FOR THE TREATMENT OF PATIENTS WITH SMALL-CELL LUNG-CARCINOMA - RESULTS OF LONG-TERM FOLLOW-UP

BACKGROUND. In an attempt to determine the efficacy of cyclophosphamid e, doxorubicin, and vincristine (CAV)/cisplatin and etoposide (PVP) hy brid chemotherapy (HYB), a rapidly alternating chemotherapy, in patien ts with small cell lung carcinoma (SCLC), the authors conducted a rand omized study to compare HYB with CAV-PVP sequential chemotherapy (SEQ) . METHODS. Patients in the HYB group received the 3-drug CAV combinati on on Day 1 and the 2-drug PVP combination on Day 8, repeated every 4 weeks for up to 6 cycles. Patients in the SEQ group received 3 cycles each of CAV and PVP sequentially every 4 weeks, delivered on Days 1 an d 8. All responding patients with limited disease (LD) received thorac ic irradiation (50 gray) after chemotherapy. RESULTS. Between April 19 88 and October 1992, 129 patients were evaluated fully. There were no significant differences in the treatment outcome between patients in t he HYB and SEQ groups in terms of the complete response rate (59% for LD patients and 21% for extensive disease [ED] patients in the HYB gro up vs. 45% for LD patients and 16% for ED patients in the SEQ group), or median survival time (17.9 months for LD patients and 9.7 months fo r ED patients in the HYB group vs. 20.6 months for LD patients and 12. 2 months for ED patients in the SEQ group). CONCLUSIONS. Hybrid CAV-PV P therapy is effective for the treatment of SCLC, but appears to be no better than sequential therapy with the same regimen. (C) 1998 Americ an Cancer Society.