OUTPATIENT TREATMENT WITH EPIRUBICIN AND ORAL ETOPOSIDE IN PATIENTS WITH SMALL-CELL LUNG-CANCER

To assess the efficacy and toxicity of an outpatient combination chemo therapy in small-cell lung cancer (SCLC), we treated 70 consecutive pa tients with epirubicin 80 mg m(-2) i.v. on day 1 and etoposide 200 mg o.d. p.o. on days 1-4 (EE) at 3-weekly intervals. The median age of pa tients was 64 years (range 39-84). The male-female ratio was 42:28 and 35 (50%) had metastatic disease. Fifty-seven patients were evaluable for response. The overall response rate was 64.4%, including 14 (23.7% ) complete responses and 24 (40.7%) partial responses. Median time to progression was 7 months in responders and 8 months in patients with l imited disease. The median survival in patients with limited disease w as 10.5 months (range 0.5-70+) and 7 months (range 0.5-24) in those wi th extensive disease. Improvement of symptoms occurred in 79% of patie nts with shortness of breath, 80% with cough, 81% with haemoptysis and 68% with pain. In 19 patients an increase in body weight was noted. M ajor (WHO grade 3/4) toxicities were neutropenia in 13 (18.5%) patient s, alopecia in 33 (47.1%) patients, mucositis in 15 (21.4%) patients, anorexia in eight patients (11.4%), nausea and vomiting in six patient s (8.5%) and diarrhoea in 4 (5.7%) patients. In conclusion, EE is an a ctive and well-tolerated outpatient regimen in the treatment of SCLC. The survival data in this unselected group of patients were disappoint ing and the possible explanations for this are discussed.