Local control of intrathoracic disease with chemotherapy and role of prophylactic cranial irradiation in small‐cell carcinoma of the lung

Roger W. Byhardt, Joseph A. Libnoch, James D. Cox, Paul Y. Holoye, Larry Kun, Ritsuko Komaki, Larry Clowry

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Between 1978 and 1979, 39 consecutive patients at the Medical College of Wisconsin were seen with small‐cell carcinoma of the lung; of these, 31 were treated with chemotherapy and prophylactic CNS irradiation (2500 rad/10 fractions) and were evaluable after 22 month median follow‐up. The intra‐thoracic primary was not irradiated unless there was no response to chemotherapy or subsequent recurrence. Of the 31 patients, 12 had limited disease (LD) and 19 had extensive disease (ED). Twenty, including all the patients with LD, had a complete response, eight had a partial response, and three were nonresponders. Of 24 patients with complete response at the primary site, 20 subsequently displayed local failure of the intrathoracic primary tumor, most developing disseminated extrathoracic disease simultaneously with or shortly after primary failure. The median survival time (MST) of the evaluable group was ten months with an actuarial one‐year survival of 39%. Patients with LD had a median remission duration of 13 months and a MST of 16 months. Three patients are still alive with no evidence of disease at 14,20, and 27 months. Of 26 patients receiving prophylactic cranial irradiation, all are free of CNS relapse. Chemotherapy alone appears insufficient to permanently control the bulky intrathoracic tumor, leading to the use of “consolidation” irradiation of moderate dose (3750 rad/15 fractions) to follow chemotherapy. Prophylactic CNS irradiation should be used routinely.

Original languageEnglish (US)
Pages (from-to)2239-2246
Number of pages8
JournalCancer
Volume47
Issue number9
DOIs
StatePublished - Jan 1 1981

Fingerprint

Cranial Irradiation
Carcinoma
Drug Therapy
Lung
Survival
Recurrence
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Local control of intrathoracic disease with chemotherapy and role of prophylactic cranial irradiation in small‐cell carcinoma of the lung. / Byhardt, Roger W.; Libnoch, Joseph A.; Cox, James D.; Holoye, Paul Y.; Kun, Larry; Komaki, Ritsuko; Clowry, Larry.

In: Cancer, Vol. 47, No. 9, 01.01.1981, p. 2239-2246.

Research output: Contribution to journalArticle

Byhardt, Roger W. ; Libnoch, Joseph A. ; Cox, James D. ; Holoye, Paul Y. ; Kun, Larry ; Komaki, Ritsuko ; Clowry, Larry. / Local control of intrathoracic disease with chemotherapy and role of prophylactic cranial irradiation in small‐cell carcinoma of the lung. In: Cancer. 1981 ; Vol. 47, No. 9. pp. 2239-2246.
@article{45762af4fa1c4905bea951d1b414882b,
title = "Local control of intrathoracic disease with chemotherapy and role of prophylactic cranial irradiation in small‐cell carcinoma of the lung",
abstract = "Between 1978 and 1979, 39 consecutive patients at the Medical College of Wisconsin were seen with small‐cell carcinoma of the lung; of these, 31 were treated with chemotherapy and prophylactic CNS irradiation (2500 rad/10 fractions) and were evaluable after 22 month median follow‐up. The intra‐thoracic primary was not irradiated unless there was no response to chemotherapy or subsequent recurrence. Of the 31 patients, 12 had limited disease (LD) and 19 had extensive disease (ED). Twenty, including all the patients with LD, had a complete response, eight had a partial response, and three were nonresponders. Of 24 patients with complete response at the primary site, 20 subsequently displayed local failure of the intrathoracic primary tumor, most developing disseminated extrathoracic disease simultaneously with or shortly after primary failure. The median survival time (MST) of the evaluable group was ten months with an actuarial one‐year survival of 39{\%}. Patients with LD had a median remission duration of 13 months and a MST of 16 months. Three patients are still alive with no evidence of disease at 14,20, and 27 months. Of 26 patients receiving prophylactic cranial irradiation, all are free of CNS relapse. Chemotherapy alone appears insufficient to permanently control the bulky intrathoracic tumor, leading to the use of “consolidation” irradiation of moderate dose (3750 rad/15 fractions) to follow chemotherapy. Prophylactic CNS irradiation should be used routinely.",
author = "Byhardt, {Roger W.} and Libnoch, {Joseph A.} and Cox, {James D.} and Holoye, {Paul Y.} and Larry Kun and Ritsuko Komaki and Larry Clowry",
year = "1981",
month = "1",
day = "1",
doi = "10.1002/1097-0142(19810501)47:9<2239::AID-CNCR2820470923>3.0.CO;2-0",
language = "English (US)",
volume = "47",
pages = "2239--2246",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - Local control of intrathoracic disease with chemotherapy and role of prophylactic cranial irradiation in small‐cell carcinoma of the lung

AU - Byhardt, Roger W.

AU - Libnoch, Joseph A.

AU - Cox, James D.

AU - Holoye, Paul Y.

AU - Kun, Larry

AU - Komaki, Ritsuko

AU - Clowry, Larry

PY - 1981/1/1

Y1 - 1981/1/1

N2 - Between 1978 and 1979, 39 consecutive patients at the Medical College of Wisconsin were seen with small‐cell carcinoma of the lung; of these, 31 were treated with chemotherapy and prophylactic CNS irradiation (2500 rad/10 fractions) and were evaluable after 22 month median follow‐up. The intra‐thoracic primary was not irradiated unless there was no response to chemotherapy or subsequent recurrence. Of the 31 patients, 12 had limited disease (LD) and 19 had extensive disease (ED). Twenty, including all the patients with LD, had a complete response, eight had a partial response, and three were nonresponders. Of 24 patients with complete response at the primary site, 20 subsequently displayed local failure of the intrathoracic primary tumor, most developing disseminated extrathoracic disease simultaneously with or shortly after primary failure. The median survival time (MST) of the evaluable group was ten months with an actuarial one‐year survival of 39%. Patients with LD had a median remission duration of 13 months and a MST of 16 months. Three patients are still alive with no evidence of disease at 14,20, and 27 months. Of 26 patients receiving prophylactic cranial irradiation, all are free of CNS relapse. Chemotherapy alone appears insufficient to permanently control the bulky intrathoracic tumor, leading to the use of “consolidation” irradiation of moderate dose (3750 rad/15 fractions) to follow chemotherapy. Prophylactic CNS irradiation should be used routinely.

AB - Between 1978 and 1979, 39 consecutive patients at the Medical College of Wisconsin were seen with small‐cell carcinoma of the lung; of these, 31 were treated with chemotherapy and prophylactic CNS irradiation (2500 rad/10 fractions) and were evaluable after 22 month median follow‐up. The intra‐thoracic primary was not irradiated unless there was no response to chemotherapy or subsequent recurrence. Of the 31 patients, 12 had limited disease (LD) and 19 had extensive disease (ED). Twenty, including all the patients with LD, had a complete response, eight had a partial response, and three were nonresponders. Of 24 patients with complete response at the primary site, 20 subsequently displayed local failure of the intrathoracic primary tumor, most developing disseminated extrathoracic disease simultaneously with or shortly after primary failure. The median survival time (MST) of the evaluable group was ten months with an actuarial one‐year survival of 39%. Patients with LD had a median remission duration of 13 months and a MST of 16 months. Three patients are still alive with no evidence of disease at 14,20, and 27 months. Of 26 patients receiving prophylactic cranial irradiation, all are free of CNS relapse. Chemotherapy alone appears insufficient to permanently control the bulky intrathoracic tumor, leading to the use of “consolidation” irradiation of moderate dose (3750 rad/15 fractions) to follow chemotherapy. Prophylactic CNS irradiation should be used routinely.

UR - http://www.scopus.com/inward/record.url?scp=0019510621&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0019510621&partnerID=8YFLogxK

U2 - 10.1002/1097-0142(19810501)47:9<2239::AID-CNCR2820470923>3.0.CO;2-0

DO - 10.1002/1097-0142(19810501)47:9<2239::AID-CNCR2820470923>3.0.CO;2-0

M3 - Article

VL - 47

SP - 2239

EP - 2246

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 9

ER -