Background: To compare the response and survival time of autologous peripheral blood stem cell assisted high-dose chemotherapy with conventional chemotherapy in treatment of small cell lung cancer (SCLC) and to access treatment-related toxicities of high-dose chemotherapy.
Methods: Twenty-seven patients with SCLC at age <= 65 yrs entered this study. Thirteen patients were given at high dose of cyclophosphamide (CTX,3. 0 g/ m(2) ) , etoposide (VP16 ,750 mg/ m(2) ) , carboplatin (CBP ,400 mg/ m(2) ) and cisplatin (DDP ,60 mg/ m(2) ) with autologous peripheral blood stem cell support by G-CSF (300mug/ d for 5 or 6 days) after one to three cycles of conventional chemotherapy with ifosfamide + vindesine + DDP ( IVP regimen) or ifosfamide + VP16 + DDP ( IEP regimen) or CTX+ VP16 + DDP (CEP regimen) . Forteen patients were given two courses of conventional chemotherapy with IVP or CEP or VP16 + DDP(EP regimen) . Patients in stage II and stage IIIA were given irradiation or surgical recection after chemotherapy and others by chemotherapy continuously.
Results: Response rate to conventional chemotherapy was 78. 6 % after one cycle and 85. 7 % after two cycles respectively , and that to high-dose chemotherapy was 100 %. The difference was not statistically significant ( P > 0. 05) . The survival time was 58 to 569 days for high-dose chemotherapy and 90 to 430 days for conventional chemotherapy respectively , and Log Rank test showed P < 0. 001. The main toxicity of high-dose chemotherapy was bone marrow suppression and all patients occured grade IV leukopenia and 61. 5 % occured grade IV thrombocytopenia , but they recovered in half month after stem cell transplantation and nobody died from high-dose chemotherapy.
Conclusions: High-dose chemotherapy with support of autologous peripheral blood stem cell is an effective therapy for SCLC. Patients has higher response and longer survival time and less toxicity.