J Med Assoc Thai 1998; 81 (1):37

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Preliminary Study of Efficacy of Intravenous Cisplatin Plus Oral Etoposide in Small Cell Lung Cancer
Chewaskulyong B Mail, Thongprasert S

Twenty-three patients with small cell lung cancer were treated with combination chemotherapy
consisting of Cisplatin at 100 mg/m2 given by 2 hours intravenous infusion on day I and
oral etoposide 25 mg/caplet given twice a day for 21 days repeated every 28 days for 6 cycles.
Of 23 cases, four cases were not evaluable due to early death (three of them died from febrile
neutropenia). Median age of the patients was 59 years (range = 45-76 years). Five cases were
female and eighteen cases were male. Median Karnofsky performance status was 70 per cent
(range = 50-90%). Five cases were extensive disease and eighteen cases were limited disease. Of
5 extensive disease cases, 1 complete response (20%) and 3 partial responses (60%) were
achieved. Of 14 limited disease patients, 1 complete response (7 .1%) and 11 partial responses
(78.6%) were achieved. Hematologic toxicities were severe causing three patients to die because
of febrile neutropenia, nine cases (10.7%) had grade 3 and 4 neutropenia. Grade 3 and 4 anemia
and thrombocytopenia were seen in 28.6 per cent and 8.3 per cent respectively. Median survival
time of all cases was 7 months.
Thus, the combination of intravenous cisplatin and prolonged administration of oral
etoposide could be administered to small cell lung cancer patients with high response rate,
however, because of its severe toxicities, special caution should be considered and the optimal
duration of oral etoposide should be evaluated.

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