A preliminary report: concurrent twice-daily radiotherapy plus platinum-etoposide chemotherapy for limited small cell lung cancer

Int J Radiat Oncol Biol Phys. 1988 Jul;15(1):183-7. doi: 10.1016/0360-3016(88)90364-1.


From July 1984 through March 1987 23 patients with small cell lung cancer have entered a trial at the University of Pennsylvania. Concurrent Platinum (DDP) Etoposide (VP-16) chemotherapy and twice-daily, 150 cGy radiotherapy to a total dose of 4500 cGy in 3 weeks was used. Besides the twice-daily radiotherapy, multiple field arrangements attempted to minimize normal tissue exposure while concentrating on the target volume. Sophisticated CT-assisted treatment planning employing beams-eye-view technology was used. Esophagitis occurred in 73% (13% severe); hematologic toxicity occurred in 65% (17% WBC less than 1000). Response--100% in pure small cell carcinoma, 91% overall. Median follow-up is 22 months with an actuarial projection of 56% 2-year survival. Median survival is not yet reached. This is a highly effective therapy with substantive but tolerable toxicity. Accrual and follow-up continues. This is a preliminary report. We expect 30 patients before closing the study. A parallel study is underway in the Eastern Cooperative Oncology Group, with a randomized prospective trial in the design stage.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Small Cell / drug therapy
  • Carcinoma, Small Cell / radiotherapy
  • Carcinoma, Small Cell / therapy*
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / radiotherapy
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Radiotherapy Dosage


  • Etoposide
  • Cisplatin