start-ver=1.4
cd-journal=joma
no-vol=99
cd-vols=
no-issue=9-10
article-no=
start-page=1167
end-page=1178
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=1987
dt-pub=19871031
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=Studies on multidisciplinary treatment of small cell lung cancer Part I. A randomized trial comparing chemotherapy alone with chemotherapy plus chest irradiation
kn-title=肺小細胞癌の集学的治療に関する研究　第1編　肺小細胞癌limited disease症例における胸部照射併用の意義について：無作為化比較試験による検討
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=In order to assess the effectiveness of chest irradiation in addition to intensive chemotherapy in the treatment of limited stage small cell lung cancer, 56 patients were randomized to receive either chemotherapy alone or chemotherapy plus chest irradiation, between April 1981 and September 1986. The chemotherapy regimen consisted of a four-drug combination of cyclophosphamide, vincristine, methotrexate and procarbazine, and a three-drug combination of VP-16, adriamycin and nimustine, given alternately every 8 weeks. One group of 28 patients received chemotherapy alone, and another group of 28 patients received chest irradiation of 40Gy, in 20 fractions over 4 weeks, between cycles 1 and 2 of the chemotherapy. Complete response rate were similar in the two groups; 46% for those receiving chemotherapy alone, and 62% for those receiving chemotherapy plus chest irradiation. There was no significant difference in the median survival time (14.5 months for chemotherapy alone versus 12.0 months for chemotherapy plus chest irradiation). The combined modality treatment was more toxic than chemotherapy alone; two patients receiving such treatment died of radiation pneumonitis. However, as far as the 3-year survival rate, there was a trend favoring patients receiving the combined modality treatment (11% versus 19%). Although additional studies are required to determine the optimal dose and schedule, timing, and selection of patients as for chest irradiation, the major need for the treatment of small cell lung cancer is better systemic chemotherapy. It seems likely that the role of chest irradiation will become more important as improved chemotherapy is developed.
en-copyright=
kn-copyright=

en-aut-name=KawaharaShin
en-aut-sei=Kawahara
en-aut-mei=Shin
kn-aut-name=河原伸
kn-aut-sei=河原
kn-aut-mei=伸
aut-affil-num=1
ORCID=

affil-num=1
en-affil=
kn-affil=岡山大学医学部第2内科教室
en-keyword=肺小細胞癌
kn-keyword=肺小細胞癌
en-keyword=limited disease
kn-keyword=limited disease
en-keyword=化学療法
kn-keyword=化学療法
en-keyword=胸部照射
kn-keyword=胸部照射
END

start-ver=1.4
cd-journal=joma
no-vol=99
cd-vols=
no-issue=9-10
article-no=
start-page=1179
end-page=1188
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=1987
dt-pub=19871031
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=Studies on multidisciplinary treatment of small cell lung cancer Part II. A randomized trial of prophylactic cranial irradiation
kn-title=肺小細胞癌の集学的治療に関する研究　第2編　肺小細胞癌症例における予防的脳照射：無作為化比較試験による検討成績
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=In order to assess the usefulness of prophylactic cranial irradiation (PCI) in the treatment of small cell lung cancer, 43 complete responders to chemotherapy were randomized either to receive PCI or to have observation only between April 1981 and September 1986. Twenty-one patients were given 40 Gy of PCI in 20 fractions over 4 weeks after they had achieved complete response. Of those, 5 patients (24%) developed brain metastases within a median follow-up period 47.5 months (range, 15.5 to 67 months), while 11 of 22 patients (50%) not receiving PCI developed brain metastases within a median follow-up period of 40.5 months (range, 13 to 70 months). Cumulative actual probability of a brain metastasis was 5% at 12 months and 25% at 24 months for those receiving PCI, while it was 38% at 12 months and 53% at 24 months for those not receiving PCI. Thus, the probability of a brain metastasis was significantly lower in the PCI group than in the control group. The median survival time was 21 months for the PCI group and 14.7 months for the control group. The 2-year survival rate was also higher in the PCI group (35% versus 14%). However, the differences were not statistically significant due to the small number of patients. These interim results suggest the possibility of reducing brain metastases and prolonging survival by PCI in complete responders to chemotherapy.
en-copyright=
kn-copyright=

en-aut-name=KawaharaShin
en-aut-sei=Kawahara
en-aut-mei=Shin
kn-aut-name=河原伸
kn-aut-sei=河原
kn-aut-mei=伸
aut-affil-num=1
ORCID=

affil-num=1
en-affil=
kn-affil=岡山大学医学部第2内科教室
en-keyword=肺小細胞癌
kn-keyword=肺小細胞癌
en-keyword=完全寛解
kn-keyword=完全寛解
en-keyword=脳転移
kn-keyword=脳転移
en-keyword=予防的脳照射
kn-keyword=予防的脳照射
END