Abstract

We conducted a phase II trial combining etoposide(VP-16), ifosfamide(IFM), and cisplatin (DDP) in previously untreated patients with histologicaliy confirmed small cell lung cancer (SCLC). Each cycle consisted of VP-16 100mg/m(2) i.v. days 1-3, IFM 1,000mg/m i.v. days 1-2 with mesna, and DDP 100mg/m(2) i.v. day 1. Cycles were repeated at 3 week intervals. Patients of limited SCLC received chest irradiation concurrently with the third cycle of VIP chemotherapy. Patients with complete remission received prophylactic cranial irradiation after the 6th cycle of chemotherapy. Thirty-seven patients were enrolled. Ages ranged from 34 to 76(median 61 years); 32 were male, and 5 female. Nineteen patients had limited disease(LD) and 18 extensive disease(ED). Three patients were not evaluable because of lost to follow up(2 patients) and early death(l patient). Of 34 evaluable patients, 13 patients(LD; 12, ED; I) had complete re- missions, 19 patients(LD: 6,ED; 13) had partial remissions and overall remission rate was 94 %. The median remission duration was 8.6 months(LD; 12.5months, D; 5.1months)..Disease free survival was 14.5 months in patients achieved complete remission. The median dura- tion of follow-up was 21 months (1 to 39 months), and overall median survival was 12.8 months(16.1 months for LD, 8.2 months for ED). Hematologic side effects(WHO Gr>=2) of evaluable 168 cycles of chemotherapy were anemia in 10 occassions(6%), leukopenia in 35 occassions(21%), thrombocytopenia in 27 occassions(16%). Nonhematologic side effects(WHO Gr>=2) included alopecia(91%), nausea and vomiting (80%), peripheral neuropathies (31%), and stomatitis (11%). In conclusion, VIP combination chemotherapy seems to be a safe, effective, and well-tolerated regimen in SCLC.

• Keywords: Small cell lung cancer, Chemotherapy, Etoposide(VP-16), Ifosfamide, Cisplatin