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Small Cell Carcinoma
Survival Not Improved With Dose-Dense Chemotherapy for Small-Cell Lung Cancer
By Journal of the National Cancer Institute
May 4, 2005, 17:26

A randomized trial has found that a dose-dense regimen of chemotherapy with blood progenitor cell support did not improve survival compared with standard-dose chemotherapy in patients with small-cell lung cancer (SCLC). However, patients who received the dose-dense regimen had fewer infections and fewer days of treatment than patients who received standard chemotherapy.

Long-term survival in patients with SCLC is poor. Studies that have tested different dose intensities of various chemotherapy regimens for SCLC have yielded conflicting results. Paul Lorigan, M.D., of Christie Hospital Manchester in England, and colleagues conducted a phase III randomized trial to determine whether doubling the dose density of ifosfamide, carboplatin, and etoposide (ICE) chemotherapy with blood-progenitor-cell support improved survival compared with standard ICE chemotherapy in patients with SCLC who had a relatively good prognosis. A total of 318 patients were randomly assigned to receive ICE chemotherapy every 4 weeks (standard arm) or every 2 weeks (dose-dense arm).

Overall survival and 2-year survival were similar in the two arms. The treatment duration was shorter in the dose-dense arm than in the standard arm, but this difference was not statistically significant.

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