A national survey of the chemotherapy regimens used to treat small cell lung cancer (SCLC) in the United Kingdom

Many chemotherapy regimens are used for treating SCLC in the United Kingdom , but it is not known, in any detail, which regimens are used, by which spe cialists, for which types of patient. We conducted a survey among all medic al and clinical oncologists, respiratory physicians and general physicians with respiratory interest in the United Kingdom to find out. The questionna ire asked for the number of SCLC patients treated annually; how many were g iven chemotherapy; the drugs, doses and schedules chosen according to progn ostic group (as defined by the clinician); and the reasons for choice of re gimen. 1214 questionnaires were sent out, and responses were received from 1070 (88%) clinicians; 266 (25%) of these treated SCLC with chemotherapy. O f 4674 patients given chemotherapy annually, 36% were given it by clinical oncologists, 30% by medical oncologists, 27% by respiratory physicians, and 7% by general physicians. In all, 34 regimens were reported with 151 diffe rent combinations of dose and schedule. In 2311 good prognosis patients, 23 regimens were used, the commonest being ACE (doxorubicin, cyclophosphamide , etoposide), ICbE (ifosfamide, carboplatin, etoposide), CAV (cyclophospham ide, doxorubicin, vincristine), CbE (carboplatin, etoposide), and PE (cispl atin, etoposide). In 1517 poor prognosis patients, 21 regimens were used, t he commonest being CAV, EV (etoposide, vincristine), CbE, CAV alternating w ith PE, and oral etoposide. 452 patients were treated regardless of prognos is and for 219 no prognostic criteria were specified. The remaining 175 wer e given second-line chemotherapy or were given regimens chosen to avoid tox icity or because of intercurrent disease or other reasons. The main reasons affecting choice of regimen were routine local practice, patients' conveni ence, quality of life considerations, trial results and cost. The results s how wide variation in routine practice and will be useful in reporting and planning clinical trials and in deciding on local treatment policies. (C) 2 001 Cancer Research Campaign.