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Journal ArticleDOI

Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide

TLDR
Four cycles of cisplatin plus etoposide and a course of radiotherapy beginning with cycle 1 of the chemotherapy resulted in overall two- and five-year survival rates of 44 percent and 23 percent, a considerable improvement in survival rates over previous results.
Abstract
Background For small-cell lung cancer confined to one hemithorax (limited small-cell lung cancer), thoracic radiotherapy improves survival, but the best ways of integrating chemotherapy and thoracic radiotherapy remain unsettled. Twice-daily accelerated thoracic radiotherapy has potential advantages over once-daily radiotherapy. Methods We studied 417 patients with limited small-cell lung cancer. All the patients received four 21-day cycles of cisplatin plus etoposide. We randomly assigned these patients to receive a total of 45 Gy of concurrent thoracic radiotherapy, given either twice daily over a three-week period or once daily over a period of five weeks. Results Twice-daily treatment beginning with the first cycle of chemotherapy significantly improved survival as compared with concurrent once-daily radiotherapy (P=0.04 by the log-rank test). After a median follow-up of almost 8 years, the median survival was 19 months for the once-daily group and 23 months for the twice-daily group. The survival rat...

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Citations
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NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines

TL;DR: Lymphedema is a common complication after treatment for breast cancer and factors associated with increased risk of lymphedEMA include extent of axillary surgery, axillary radiation, infection, and patient obesity.
Journal ArticleDOI

Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group.

TL;DR: Prophylactic cranial irradiation improves both overall survival and disease-free survival among patients with small-cell lung cancer in complete remission and identifies a trend toward a decrease in the risk of brain metastasis with earlier administration of cranials irradiation after the initiation of induction chemotherapy.
Journal ArticleDOI

Small Cell Lung Cancer

TL;DR: Evidence-based guidelines for the staging and treatment of SCLC are outlined and it is suggested that patients achieving a complete remission should be offered prophylactic cranial irradiation.
Journal ArticleDOI

Small Cell Lung Cancer

TL;DR: Combination chemotherapy, generally platinum-based plus etoposide or irinotecan, is the mainstay first-line treatment for metastatic small-cell lung cancer as discussed by the authors.
Journal ArticleDOI

Multidisciplinary management of lung cancer.

TL;DR: This review considers the treatment of each type of lung cancer in the framework of multidisciplinary management and recent clinical trials for the more aggressive small-cell lung cancer.
References
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Book ChapterDOI

Nonparametric Estimation from Incomplete Observations

TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
Book ChapterDOI

Regression Models and Life-Tables

TL;DR: The analysis of censored failure times is considered in this paper, where the hazard function is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time.
Journal ArticleDOI

Use of Ranks in One-Criterion Variance Analysis

TL;DR: In this article, a test of the hypothesis that the samples are from the same population may be made by ranking the observations from from 1 to Σn i (giving each observation in a group of ties the mean of the ranks tied for), finding the C sums of ranks, and computing a statistic H. Under the stated hypothesis, H is distributed approximately as χ2(C − 1), unless the samples were too small, in which case special approximations or exact tables are provided.
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