Duration of Chemotherapy in Small Cell Lung Cancer
Author Information
Author(s): S.G. Spiro, R.L. Souhami, D.M. Geddes, C.M. Ash, H. Quinn, P. G. Harper, J.S. Tobias, M. Partridge, D. Eraut
Primary Institution: Brompton Hospital, London
Hypothesis
Does the duration of initial chemotherapy affect survival in patients with small cell lung cancer?
Conclusion
Limiting treatment to four courses of chemotherapy alone is associated with inferior survival compared to other treatment options.
Supporting Evidence
- Patients receiving four courses of chemotherapy had a median survival of 30 weeks.
- Patients receiving eight courses had a median survival of 39 weeks.
- Response rates after four courses were 61% and after eight courses were 63%, showing no significant increase.
Takeaway
This study found that giving only four courses of chemotherapy for small cell lung cancer leads to shorter survival than giving more courses or additional treatment later.
Methodology
Patients were randomized to receive either four or eight courses of chemotherapy and then further randomized to receive second-line chemotherapy or symptomatic treatment upon disease progression.
Potential Biases
Patients with poor performance status were less likely to receive second-line chemotherapy.
Limitations
Some patients did not complete the assigned chemotherapy, and there were biases in treatment allocation at relapse.
Participant Demographics
Median age was 62 years; 68.4% were male and 31.6% female.
Statistical Information
P-Value
P=0.003
Statistical Significance
p<0.01
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