Combined therapy for 442 patients with limited small cell lung cancers

Objective: To compare the survival rates of sequential versus alternating modalities of radiotherapy and chemotherapy for limited small cell lung cancer (SCLC). Methods: From January 1983 to December 1995, 442 patients with limited SCLC were randomized into two groups: 228 patients in the sequential arm( S ), 214 patients in the alternating arm (A ) . Radiation was started after two cycles of chemotherapy in arm A and after the fourth cycle in arm S. All patients received conventional radiotherapy. The total tumor dose was 50-70 Gy/ 5-7 weeks. The radiation fields covered the primary tumor, draining hilar lymphatics, partial mediastinum and bilateral supraclavicular areas. Results: The overall response rate (CR + PR ) was 78.1%. The median survival time was 15.6 months in arm S, and 12.0 months in arm A. The 1- , 3- and 5-year survival rates were 54.5%, 20.9%, 17.1% in arm S, and 65.1%, 18.3%, 17.6% in arm A (P=0.69). The frequencies of local recurrence were 34.6% and 35.0%, and distant metastasis were 57.5% and 57.9% in arms S and A. Conclusion: No obvious difference is observed in comparing the survival, recurrence and metastasis between arm A and arm B in the presented study