A randomised trial of planned versus as required chemotherapy in small cell lung cancer: a Cancer Research Campaign trial
1991

Chemotherapy for Small Cell Lung Cancer: Planned vs. As Required

Sample size: 300 publication Evidence: moderate

Author Information

Author(s): H.M. Earl, R.M. Rudd, S.G. Spiro, C.M. Ash, L.E. James, C.S. Law, J.S. Tobias, P.G. Harper, D.M. Geddes, D. Eraut, M.R. Partridge, R.L. Souhami

Primary Institution: University College and Middlesex School of Medicine

Hypothesis

Does chemotherapy treatment given on an 'as required' basis result in equivalent survival with a better quality of life?

Conclusion

Chemotherapy on an 'as required' basis did not significantly worsen survival compared to planned chemotherapy, but resulted in worse quality of life.

Supporting Evidence

  • Patients receiving AR chemotherapy had a median survival of 32 weeks.
  • Patients receiving planned chemotherapy had a median survival of 36 weeks.
  • Quality of life assessments showed AR patients reported more severe symptoms.
  • Patients with longer treatment-free intervals had better survival outcomes.
  • AR patients received approximately half the amount of chemotherapy compared to planned patients.

Takeaway

Doctors tested two ways to give chemotherapy to lung cancer patients: regularly or only when needed. Both ways helped patients live about the same time, but the regular way made them feel better overall.

Methodology

300 patients with small cell lung cancer were randomized to receive either planned chemotherapy every 3 weeks or chemotherapy as required based on symptoms.

Potential Biases

Potential bias in patient perception of treatment effectiveness and quality of life assessments.

Limitations

The study did not assess long-term survival beyond the treatment period and focused primarily on short-term quality of life.

Participant Demographics

Patients were under 76 years of age, with both limited and extensive disease stages, and included both male and female participants.

Statistical Information

P-Value

0.013

Confidence Interval

95% C.I. 32-40 weeks for planned, 95% C.I. 28-37 weeks for AR

Statistical Significance

p=0.960

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