Survival and local control rates for limited stage small-cell
lung cancer patients treated with either once-daily or twice-daily
thoracic radiation plus cisplatin (Platinol) and etoposide (VePesid)
are substantially better than with previously reported treatment
regimens, preliminary results of RTOG 88-15 indicate.
The 358 eligible patients were randomized to one of two arms of
the study. In one arm, patients received thoracic irradiation
once a day to a total dose of 45 Gy in 5 weeks.
In the other arm, patients received 1.5 Gy twice daily to a total
dose of 45 Gy in 3 weeks.
All patients underwent the same chemotherapy regimen of four cycles
of cisplatin (60 mg/m² on day one of radiation treatment)
and etoposide (120 mg/m² on days one, two, and three). This
regimen was repeated at 21-day intervals.
Patients with complete response underwent prophylactic cranial
irradiation (25 Gy given in 10 fractions over 2 weeks).
The median survival for patients treated twice a day with radiation
was 20.3 months, said Dr. Wally Curran, an author of the study.
It was 18.6 months for patients treated once a day, he said. That
compares to about 14 months for patients who undergo standard
treatment. The local failure rate was 61% for patients treated
daily, and 48% for those treated twice daily.
According to Dr. Curran, 15% of patients treated daily had grade
3 or worse toxicities, compared with 30% for those treated twice
"Because we observed better local control and survival rates,
RTOG is continuing to pursue twice-daily treatment as a schedule
for limited stage small-cell lung cancer patients," said
Dr. Curran. RTOG has two limited stage small-cell lung cancer
trials open: RTOG 93-07 and RTOG 93-12.
RTOG 88-15 was an intergroup trial, coordinated by the Eastern
Cooperative Oncology Group. RTOG contributed about one-third of
the patients to the study.
The results of RTOG 88-15 were presented at the recent annual
meeting of the American Society for Therapeutic Radiology and