Intensive combined chemotherapy and radiotherapy in patients with nonresectable bronchogenic carcinoma

Abstract

A treatment program utilizing combinations of antineoplastic agents was evaluated in 46 unresectable untreated patients with bronchogenic carcinoma. Following specific staging procedures, patients considered to have “limited” disease apparently confined to one hemithorax and ipsilateral supraclavicular area were treated, in addition, with cobalt-60 radiotherapy, receiving 5000 R in a 6-week period. The median survival for patients with “limited” disease was 13 months with 9 of 27 patients (33%) currently alive, vs. 4 months for patients with “extensive” disease and with 2 of 17 patients (12%) still alive. Determination of objective response to the combined treatment was possible in 36 patients, and it occurred in 22 (61%). Responders lived significantly longer (median 365 days) than nonresponders (median 130 days). The objective response rate was highest and the survival longest in patients with adenocarcinoma and small cell undifferentiated carcinoma of the lung. The data suggest that the principle of staging and treatment as utilized in the current study might have a place in the management of inoperable lung cancer and contribute to the prolongation of survival.