Long-term Effects of Intravenous Hyperalimentation Administered During Intensive Chemotherapy for Small Cell Bronchogenic Carcinoma

Cancer. 1987 Jan 15;59(2):362-9. doi: 10.1002/1097-0142(19870115)59:2<362::aid-cncr2820590233>3.0.co;2-j.

Abstract

Sixty-five patients with small cell bronchogenic carcinoma received their first two of three courses of intensive induction chemotherapy with (30 patients) or without (35 patients) intravenous hyperalimentation (IVH). Patients predominantly had extensive disease (55%), Zubrod's performance status 0 to 2 (63%) and less than or equal to 6% pretreatment weight loss (68%). Both treatment arms were comparable by prognostic factors. The chemotherapy included six remission induction courses of ECHO chemotherapy (E: epipodophyllotoxin VP-16-213; C: cyclophosphamide; H: hydroxydaunorubicin; O: oncovin [vincristine]) followed by six courses of maintenance with PRIME (PR: procarbazine; I: ifosfamide; ME: methotrexate). Prophylactic brain irradiation was given to all patients. Patients with limited disease received chest irradiation at the completion of ECHO. Fifty of 52 (96%) evaluable patients responded with a complete (56%) or partial (40%) remission. The complete remission (CR) rate was higher in the control arm (66% versus 43%; P = 0.11). Response duration and survival of patients was similar for both treatment arms. Combined median survival duration for all patients with limited and extensive disease was 15.75 and 11.50 months, respectively. Combined median survival duration for CR patients with limited and extensive disease was 25 and 13 months, respectively. Administration of IVH did not ameliorate the hematologic, gastrointestinal and infectious morbidity of ECHO chemotherapy. The IVH was effective in preserving body weight and improving delayed hypersensitivity reaction to a battery of skin test antigens. Administration of intensive ECHO chemotherapy to patients with small cell bronchogenic carcinoma resulted in high response rates, acceptable toxicities and improved survival. Administration of IVH did not improve the short- and long-term results of chemotherapy, and did not ameliorate its morbidity. Nutritional support, however, was helpful in preventing patient's weight loss.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Body Weight
  • Carcinoma, Bronchogenic / drug therapy
  • Carcinoma, Bronchogenic / therapy*
  • Carcinoma, Small Cell / drug therapy
  • Carcinoma, Small Cell / therapy*
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Female
  • Humans
  • Hypersensitivity, Delayed
  • Ifosfamide / therapeutic use
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / therapy*
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Parenteral Nutrition, Total*
  • Procarbazine / therapeutic use
  • Prognosis
  • Vincristine / therapeutic use

Substances

  • Procarbazine
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Ifosfamide
  • Methotrexate

Supplementary concepts

  • ECHO protocol
  • PRIME protocol