ABBREVIATED TREATMENT FOR ELDERLY, INFIRM, OR NONCOMPLIANT PATIENTS WITH LIMITED-STAGE SMALL-CELL LUNG-CANCER

Purpose: To evaluate the efficacy of an abbreviated treatment plan con sisting of two cycles of chemotherapy plus thoracic irradiation in a p opulation of limited-stage small-cell lung cancer (LSCLC) patients who were elderly, infirm, or noncompliant with standard-duration therapy. Patients and Methods: Fifty-five LSCLC patients (median age, 73) were treated with one cycle of cyclophosphamide, doxorubicin, and vincrist ine (CAV) followed 3 weeks later by one cycle of etoposide and cisplat in (EP). Both regimens were administered at conventional full dose. Th oracic irradiation (20 to 30 Gy) was delivered concurrently with EP. R esults: Complete response occurred in 28 patients (51%) and partial re sponse in 21 (38%). The median survival time was 54 weeks; the 2-year survival rate was 28% and the actual 5-year survival rate was 18%. Thr ee patients died of toxicity. Conclusion: Elderly, infirm, or noncompl iant LSCLC patients who are unable to receive standard-duration chemot herapy may have useful palliation and potential for long-term survival with abbreviated chemotherapy (two cycles) and thoracic irradiation. (C) 1998 by American Society of Clinical Oncology.