Abstract

The present randomized, prospective study was designed to assess whether alternating etoposide, cisplatin (EP) and cyclophosphamide, adriamycin, vincristine (CAV) is better than etoposide, cisplatin (EP) chemotherapy in improving response, survival and remission duration in 62 evaluable patients having extensive-stage small-cell lung cancer.(SCLC) There were no significant differences in treatment outcome for EP alone, EP/CAV in terms of response rate (65/ versus 75%), complete response rate (9% versus 7%), remission duration (5 months versus 5 months) or median survival (10 months versus 1 l months). Severe myelosuppressian was more common in EPiCAV alternating treatment. The EP/CAV alternating regimen and EP alone regimen can be considered equivalently effective induction therapies in extensive SCLC and these two regimens are, to some degree, cross resistant. Alternating therapy provides no therapeutic advantage with more myelosuppression compared to the EP alone chemotherapy and should not be considered as standard treatment in this clinical setting.

• Keywords: Small cell lung cancer, combination chemotherapy