Ten-year follow-up of Southwest Oncology Group 8269

A phase II trial of concomitant cisplatin-etoposide and daily thoracic radiotherapy in limited small-cell lung cancer

Charles R. Thomas, Dorothy J. Giroux, Lalitha M. Janaki, Andrew T. Turrisi, John J. Crowley, Sarah A. Taylor, J. Dean McCracken, P. G. Shankir Giri, William Gordon, Robert B. Livingston, David R Gandara

Research output: Contribution to journalArticle

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Abstract

Purpose: To report the long-term follow-up of Southwest Oncology Group-8269, a phase II North American cooperative group trial of concurrent cisplatin, etoposide, vincristine (PEV), and thoracic radiotherapy (TRT) for limited small-cell lung cancer (L-SCLC). Methods: 114 eligible patients from 47 institutions enrolled between April, 1985 and March 1986. Patients had documented L-SCLC. Induction chemotherapy consisted of three cycles of PEV. TRT was administered at 1.8 Gy/fraction in 25 daily fractions to a total dose of 45 Gy, to begin concomitantly. Consolidative chemotherapy included two cycles of vincristine, methotrexate, etoposide, doxorubicin and cyclophosphamide. Prophylactic cranial irradiation (PCI) was concurrent with the 3rd cycle of chemotherapy. The PCI dose was 30 Gy in 15 fractions of 2 Gy/fraction. Results: As of May 2000, 5 of 114 remain alive and progression-free with a minimum follow-up interval of 13.2 years, as of May 2000. The median follow-up interval is 14.2 years. Thirty eight patients died of causes other than SCLC and five patients are still alive and progression-free. Of the remaining 71 patients dying of SCLC, local failure (LF) occurred in 24% (17 patients), distant metastasis (DM) occurred in 35% (25 patients), simultaneous LF and DM occurred in 25% (18 patients), and was indeterminate in 16% (11 patients). Thus, LF was a component of failure in 49%. Twenty patients had the CNS as the initial site of failure. Eleven patients (10%) developed fatal second primary cancers, including two with acute myelogenous leukemia, two with squamous cell lung cancer, one each with breast, pancreas, prostate, renal cell, and myelodysplasia. One patient developed both a melanoma and non-Hodgkin's lymphoma. Conclusion: There are long-term survivors with concomitant TRT and PEV. LF and DM are common. Pattern of failure suggests needs to improve local and systemic control.

Original languageEnglish (US)
Pages (from-to)213-219
Number of pages7
JournalLung Cancer
Volume33
Issue number2-3
DOIs
StatePublished - 2001

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Small Cell Lung Carcinoma
Etoposide
Cisplatin
Radiotherapy
Thorax
Cranial Irradiation
Vincristine
Neoplasm Metastasis
Drug Therapy
Squamous Cell Neoplasms
Induction Chemotherapy
Second Primary Neoplasms
Acute Myeloid Leukemia
Methotrexate
Non-Hodgkin's Lymphoma
Doxorubicin
Cyclophosphamide
Survivors
Prostate
Pancreas

ASJC Scopus subject areas

  • Oncology

Cite this

Ten-year follow-up of Southwest Oncology Group 8269 : A phase II trial of concomitant cisplatin-etoposide and daily thoracic radiotherapy in limited small-cell lung cancer. / Thomas, Charles R.; Giroux, Dorothy J.; Janaki, Lalitha M.; Turrisi, Andrew T.; Crowley, John J.; Taylor, Sarah A.; McCracken, J. Dean; Shankir Giri, P. G.; Gordon, William; Livingston, Robert B.; Gandara, David R.

In: Lung Cancer, Vol. 33, No. 2-3, 2001, p. 213-219.

Research output: Contribution to journalArticle

Thomas, CR, Giroux, DJ, Janaki, LM, Turrisi, AT, Crowley, JJ, Taylor, SA, McCracken, JD, Shankir Giri, PG, Gordon, W, Livingston, RB & Gandara, DR 2001, 'Ten-year follow-up of Southwest Oncology Group 8269: A phase II trial of concomitant cisplatin-etoposide and daily thoracic radiotherapy in limited small-cell lung cancer', Lung Cancer, vol. 33, no. 2-3, pp. 213-219. https://doi.org/10.1016/S0169-5002(01)00181-7
Thomas, Charles R. ; Giroux, Dorothy J. ; Janaki, Lalitha M. ; Turrisi, Andrew T. ; Crowley, John J. ; Taylor, Sarah A. ; McCracken, J. Dean ; Shankir Giri, P. G. ; Gordon, William ; Livingston, Robert B. ; Gandara, David R. / Ten-year follow-up of Southwest Oncology Group 8269 : A phase II trial of concomitant cisplatin-etoposide and daily thoracic radiotherapy in limited small-cell lung cancer. In: Lung Cancer. 2001 ; Vol. 33, No. 2-3. pp. 213-219.
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abstract = "Purpose: To report the long-term follow-up of Southwest Oncology Group-8269, a phase II North American cooperative group trial of concurrent cisplatin, etoposide, vincristine (PEV), and thoracic radiotherapy (TRT) for limited small-cell lung cancer (L-SCLC). Methods: 114 eligible patients from 47 institutions enrolled between April, 1985 and March 1986. Patients had documented L-SCLC. Induction chemotherapy consisted of three cycles of PEV. TRT was administered at 1.8 Gy/fraction in 25 daily fractions to a total dose of 45 Gy, to begin concomitantly. Consolidative chemotherapy included two cycles of vincristine, methotrexate, etoposide, doxorubicin and cyclophosphamide. Prophylactic cranial irradiation (PCI) was concurrent with the 3rd cycle of chemotherapy. The PCI dose was 30 Gy in 15 fractions of 2 Gy/fraction. Results: As of May 2000, 5 of 114 remain alive and progression-free with a minimum follow-up interval of 13.2 years, as of May 2000. The median follow-up interval is 14.2 years. Thirty eight patients died of causes other than SCLC and five patients are still alive and progression-free. Of the remaining 71 patients dying of SCLC, local failure (LF) occurred in 24{\%} (17 patients), distant metastasis (DM) occurred in 35{\%} (25 patients), simultaneous LF and DM occurred in 25{\%} (18 patients), and was indeterminate in 16{\%} (11 patients). Thus, LF was a component of failure in 49{\%}. Twenty patients had the CNS as the initial site of failure. Eleven patients (10{\%}) developed fatal second primary cancers, including two with acute myelogenous leukemia, two with squamous cell lung cancer, one each with breast, pancreas, prostate, renal cell, and myelodysplasia. One patient developed both a melanoma and non-Hodgkin's lymphoma. Conclusion: There are long-term survivors with concomitant TRT and PEV. LF and DM are common. Pattern of failure suggests needs to improve local and systemic control.",
author = "Thomas, {Charles R.} and Giroux, {Dorothy J.} and Janaki, {Lalitha M.} and Turrisi, {Andrew T.} and Crowley, {John J.} and Taylor, {Sarah A.} and McCracken, {J. Dean} and {Shankir Giri}, {P. G.} and William Gordon and Livingston, {Robert B.} and Gandara, {David R}",
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T1 - Ten-year follow-up of Southwest Oncology Group 8269

T2 - A phase II trial of concomitant cisplatin-etoposide and daily thoracic radiotherapy in limited small-cell lung cancer

AU - Thomas, Charles R.

AU - Giroux, Dorothy J.

AU - Janaki, Lalitha M.

AU - Turrisi, Andrew T.

AU - Crowley, John J.

AU - Taylor, Sarah A.

AU - McCracken, J. Dean

AU - Shankir Giri, P. G.

AU - Gordon, William

AU - Livingston, Robert B.

AU - Gandara, David R

PY - 2001

Y1 - 2001

N2 - Purpose: To report the long-term follow-up of Southwest Oncology Group-8269, a phase II North American cooperative group trial of concurrent cisplatin, etoposide, vincristine (PEV), and thoracic radiotherapy (TRT) for limited small-cell lung cancer (L-SCLC). Methods: 114 eligible patients from 47 institutions enrolled between April, 1985 and March 1986. Patients had documented L-SCLC. Induction chemotherapy consisted of three cycles of PEV. TRT was administered at 1.8 Gy/fraction in 25 daily fractions to a total dose of 45 Gy, to begin concomitantly. Consolidative chemotherapy included two cycles of vincristine, methotrexate, etoposide, doxorubicin and cyclophosphamide. Prophylactic cranial irradiation (PCI) was concurrent with the 3rd cycle of chemotherapy. The PCI dose was 30 Gy in 15 fractions of 2 Gy/fraction. Results: As of May 2000, 5 of 114 remain alive and progression-free with a minimum follow-up interval of 13.2 years, as of May 2000. The median follow-up interval is 14.2 years. Thirty eight patients died of causes other than SCLC and five patients are still alive and progression-free. Of the remaining 71 patients dying of SCLC, local failure (LF) occurred in 24% (17 patients), distant metastasis (DM) occurred in 35% (25 patients), simultaneous LF and DM occurred in 25% (18 patients), and was indeterminate in 16% (11 patients). Thus, LF was a component of failure in 49%. Twenty patients had the CNS as the initial site of failure. Eleven patients (10%) developed fatal second primary cancers, including two with acute myelogenous leukemia, two with squamous cell lung cancer, one each with breast, pancreas, prostate, renal cell, and myelodysplasia. One patient developed both a melanoma and non-Hodgkin's lymphoma. Conclusion: There are long-term survivors with concomitant TRT and PEV. LF and DM are common. Pattern of failure suggests needs to improve local and systemic control.

AB - Purpose: To report the long-term follow-up of Southwest Oncology Group-8269, a phase II North American cooperative group trial of concurrent cisplatin, etoposide, vincristine (PEV), and thoracic radiotherapy (TRT) for limited small-cell lung cancer (L-SCLC). Methods: 114 eligible patients from 47 institutions enrolled between April, 1985 and March 1986. Patients had documented L-SCLC. Induction chemotherapy consisted of three cycles of PEV. TRT was administered at 1.8 Gy/fraction in 25 daily fractions to a total dose of 45 Gy, to begin concomitantly. Consolidative chemotherapy included two cycles of vincristine, methotrexate, etoposide, doxorubicin and cyclophosphamide. Prophylactic cranial irradiation (PCI) was concurrent with the 3rd cycle of chemotherapy. The PCI dose was 30 Gy in 15 fractions of 2 Gy/fraction. Results: As of May 2000, 5 of 114 remain alive and progression-free with a minimum follow-up interval of 13.2 years, as of May 2000. The median follow-up interval is 14.2 years. Thirty eight patients died of causes other than SCLC and five patients are still alive and progression-free. Of the remaining 71 patients dying of SCLC, local failure (LF) occurred in 24% (17 patients), distant metastasis (DM) occurred in 35% (25 patients), simultaneous LF and DM occurred in 25% (18 patients), and was indeterminate in 16% (11 patients). Thus, LF was a component of failure in 49%. Twenty patients had the CNS as the initial site of failure. Eleven patients (10%) developed fatal second primary cancers, including two with acute myelogenous leukemia, two with squamous cell lung cancer, one each with breast, pancreas, prostate, renal cell, and myelodysplasia. One patient developed both a melanoma and non-Hodgkin's lymphoma. Conclusion: There are long-term survivors with concomitant TRT and PEV. LF and DM are common. Pattern of failure suggests needs to improve local and systemic control.

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