A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer

Article Abstract:

Patients with non-small-cell cancer of the lung are usually considered incurable by surgery and are treated by radiation therapy. The results of this therapy are also poor, however. The present study examines the utility of treating a specific diagnostic subgroup of these patients (those with stage III tumors) with a combined chemo- and radiotherapeutic approach. A chemotherapeutic approach is considered for these patients because these tumors tend to spread by microscopic metastases (islands of tumors) throughout the body and are impossible to treat by surgery. A study group of 155 patients was divided into two groups. The combined group (78) received a cisplatin-vinblastine treatment before starting a 6-week radiotherapy course of treatment, while the remaining 77 patients received only the radiotherapy treatment. The survival rates of the two groups were analyzed. Patients in the combined group had an increased average survival time (13.8 versus 9.7 months) over those patients treated solely with radiation. Survival rate of the combined group was 55 percent at one year, decreasing to 26 percent after two years, and 23 percent at three years. For the radiation-only group, these survival rates at those times were 40, 13, and 11 percent, respectively. The cost of radiation therapy was approximately $14,000, and the costs associated with the chemotherapy pretreatment were $3,500, a 33 percent increase in the cost of combined treatment, but providing a 100 percent increase in survival at years two and three. The study demonstrates an average improvement in survival time of only four months, and suggests that even with the more aggressive combined approach, 75 percent of this group of cancer patients are dead within 3 years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Radiotherapy, Lung cancer, Non-small cell, Non-small cell lung cancer

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A randomized comparison of methotrexate dose and the addition of bleomycin to CHOP therapy for diffuse large cell lymphoma and other non-Hodgkin's lymphomas

Article Abstract:

The effectiveness of adding the anticancer agents bleomycin or methotrexate to standard therapy for non-Hodgkin's lymphoma, a cancer of the lymphatic system, was assessed in afflicted patients recruited between 1978 and 1985. The study included 177 patients with diffuse large cell lymphoma (DLCL) and 97 patients with intermediate-grade non-Hodgkin's lymphoma. The patients received three courses of therapy with cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP) every three weeks, with or without bleomycin. Patients who responded to initial treatment were given methotrexate in a high dose of three grams (gm) per square meter of body area per week or standard dose of 30 milligrams (mg) per square meter per week, for three weeks. This was followed by three additional courses of CHOP. Bleomycin or high dose methotrexate did not improve responses of patients with DLCL, who had complete response rates ranging from 47 to 51 percent. The average duration of survival was 12 months, and the survival rate at five years was 27 percent. The addition of bleomycin or methotrexate to standard treatment with CHOP did not improve survival of patients with non-Hodgkin's lymphoma. The five-year survival rate was 47 percent in patients with follicular large cell lymphoma. Survival rates were poorest among patients with other subtypes of diffuse or widespread lymphomas. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Antineoplastic agents, Non-Hodgkin's lymphomas, Dosage and administration, Methotrexate, Bleomycin

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Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD

Article Abstract:

Treatment with doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) may be as effective as treatment with mechlorethamine, vincristine, procarbazine and prednisone (MOPP) alternating with ABVD for patients with advanced Hodgkin's disease. Treatment with MOPP alone may be less effective. Among 361 patients with advanced Hodgkin's disease, 123 were treated with MOPP, 123 were treated with MOPP alternated with ABVD and 115 were treated with ABVD. Eighty-two percent of the patients treated with ABVD and 83% of the patients treated with MOPP and ABVD experienced a complete response to treatment compared with 67% of those treated with MOPP. Seventy-three percent of the patients in the ABVD group and 75% of those in the MOPP-ABVD group were alive five years after treatment, compared with 66% of those in the MOPP group.

Usage, Hodgkin's disease, Drug therapy

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