Combination modality therapy in lung cancer. A survival study showing beneficial results of AMCOF (adriamycin, methotrexate, cyclophosphamide, oncovin and 5-fluorouracil)
✍ Scribed by Dr. Colonel Ralph D. Reynolds; Colonel Stanley O'dell
- Publisher
- John Wiley and Sons
- Year
- 1978
- Tongue
- English
- Weight
- 418 KB
- Volume
- 42
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Thirty-seven patients with advanced or recurrent lung cancer were randomized to cytoxan (CTX) alone, COMF (CTX, oncovin, methotrexate and 5-FU) or AMCOF (adriamycin, methotrexate, CTX, oncovin and 5-FU) after receiving radiation therapy to primary and bulky tumor sites. Median survival was 3 months for CTX, 6 months for COMF and 14 months for AMCOF. Analysis of those with oat cell (small cell) carcinoma showed median survival of 8.5 months. Oat cell cases treated with CTX survived 5 months (8 patients) with COMF 7.5 months (15 patients) and with AMCOF 13 months (14 patients). The median survival of those with adenocarcinoma or epidermoid carcinoma treated with CTX survived 3 months, with COMF 6 months and with AMCOF 15.5 months. Toxicity was moderate though no life-threatening toxicity developed in spite of the protocol design of escalation to achieve some degree of hematologic toxicity in all patients.
Cancer 42:385-389, 1978.
E TREATMENT OF LUNG CANCER con-MATERIALS A N D METHODS tinues to be the biggest challenge in oncology today. The incidence has been All Patients had histolOgicallY Proven steadily increasing and it now results in more Stage 111 or recurrent carcinoma of the deaths than any other type of cancer.1.6 Most lung. The histopathologic slides were recases present with advanced disease and the viewed by the three institutional pathologists median survival of four months remains un-and by the Armed FOrced Institute of altered by modern methods of therapy. Only Pathology referee. The terms oat cell and oat cell carcinoma has yielded to the thera-small cell carcinoma are used interchangeably peutic attempts and this success has yet to in this report. produce consistent median survival exceeding Initial random number randomization be- one year.2*3s4,5 tween cyclophosphamide (CTX) alone and This report demonstrates the potential combination chemotherapy with cYcloPhosusefulness of combined modality therapy phamide, methotrexate, vincristine and 5in advanced lung cancer using radiotherapy fl~orouracil (COMF) began in 1972. Neither followed by combination chemotherapy. Im-cell type nor radiotherapy was stratified. pressive survival figures in oat cell car-When it apparent that CTX was cinoma were the most notable findings.
ineffective, randomization was changed to COMF versus AMCOF (adriamycin, methotrexate, cyclophosphamide, vincristine and AMCOF.
From the David Grant Medical Center, Travis Air