Views: 1,295 | Downloads:
24
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Phase II Study of Ifosfamide, Carboplatin, Etoposide and GM-CSF in Small Cell Lung Cancer
Thongprasert S 
Twenty patients with small cell lung cancer (SCLC) were entered to the study. Fourteen
cases were male and six cases were female. Twelve cases were extensive disease, eight cases
were limited disease. Median age was 60 years (range=40-72 years), median performance status
was 70 per cent (range=60-80% ). All patients were treated with combination chemotherapy
consisting of ifosfamide 5 g/m
2
intravenous infusion over 4 hours with mesna uroprotection,
carboplatin 300 mg/m
2
intravenous infusion over 2 hours on day 1, and etoposide 120 mg/m
2
intravenous infusion over 4 hours on day 1-3. Chemotherapy was re-cycled every 28 days.
Assessment of hematologic toxicity (CBC) was performed two times per week. If there was
grade 3 or 4 neutropenia on any cycle of chemotherapy, GM-CSF was administered for febrile
neutropenia and on the next cycle it was administered prophylactically on day 4-14.
Results : Seventeen cases were evaluable for response and toxicity (three cases were in-
evaluable due to loss to follow-up after the first cycle of chemotherapy). Fourteen cases (five
limited disease, nine extensive disease) achieved partial response (82.5%). Two cases had stable
disease, one case died on day 7. One year survival was 23.5 per cent. Seventy and a half percent
grade 3 and 4 neutropenia was seen during the first cycle. One patient had febrile neutropenia. After
being prophylactically treated with GM-CSF, grade 3 and 4 neutropenia was reduced from 70.5
per cent to 56.2 per cent, 46.7 per cent, 63.6 per cent, 42.8 per cent and 0 per cent in cycle 2-6
respectively. Major toxicity of GM -CSF consisted of transient chest distress, chills, sweating and
hypotension which subsided in 5-10 minutes. No fever or skin rash was observed.
Conclusion : Combination of ifosfamide, carboplatin and etoposide (ICE) is an active
regimen for small cell lung cancer. However, because of its severe myelosuppression, this
regimen needs hematopoietic growth factor support, and GM-CSF was used in this study. The
administration of GM-CSF rendered ICE chemotherapy to be given safely.
Key word : Small Cell Lung Cancer, Chemotherapy, GM-CSF
cases were male and six cases were female. Twelve cases were extensive disease, eight cases
were limited disease. Median age was 60 years (range=40-72 years), median performance status
was 70 per cent (range=60-80% ). All patients were treated with combination chemotherapy
consisting of ifosfamide 5 g/m
2
intravenous infusion over 4 hours with mesna uroprotection,
carboplatin 300 mg/m
2
intravenous infusion over 2 hours on day 1, and etoposide 120 mg/m
2
intravenous infusion over 4 hours on day 1-3. Chemotherapy was re-cycled every 28 days.
Assessment of hematologic toxicity (CBC) was performed two times per week. If there was
grade 3 or 4 neutropenia on any cycle of chemotherapy, GM-CSF was administered for febrile
neutropenia and on the next cycle it was administered prophylactically on day 4-14.
Results : Seventeen cases were evaluable for response and toxicity (three cases were in-
evaluable due to loss to follow-up after the first cycle of chemotherapy). Fourteen cases (five
limited disease, nine extensive disease) achieved partial response (82.5%). Two cases had stable
disease, one case died on day 7. One year survival was 23.5 per cent. Seventy and a half percent
grade 3 and 4 neutropenia was seen during the first cycle. One patient had febrile neutropenia. After
being prophylactically treated with GM-CSF, grade 3 and 4 neutropenia was reduced from 70.5
per cent to 56.2 per cent, 46.7 per cent, 63.6 per cent, 42.8 per cent and 0 per cent in cycle 2-6
respectively. Major toxicity of GM -CSF consisted of transient chest distress, chills, sweating and
hypotension which subsided in 5-10 minutes. No fever or skin rash was observed.
Conclusion : Combination of ifosfamide, carboplatin and etoposide (ICE) is an active
regimen for small cell lung cancer. However, because of its severe myelosuppression, this
regimen needs hematopoietic growth factor support, and GM-CSF was used in this study. The
administration of GM-CSF rendered ICE chemotherapy to be given safely.
Key word : Small Cell Lung Cancer, Chemotherapy, GM-CSF
Download:
PDF