143

had responded to induction therapy (CR or P~) received CYC 180 mgs/kg and VP-16 1 g/

m over 24 hours with ABMS. There was 1 treatment-related death (cardiotoxicity, CYC > 200 mg/kg). Myelosuppression was si- milar and predictable in bo~h groups with mean neutropenia (<500 x i0-/i) periods of 12.5 and 13 days respectively. Mucosi- tis was the only additional toxicity en- countered with the 2 drug LDI. Further tumour regression was evident in 16 of 20 patients in the first study and 5 of ii patients in the second. However, responses were generally short lived, median actual survival for limited disease (LD) in the first study, 12.5 months and extensive disease (ED) 8 months. In the second study median actual survival in LD was 12 months and for ED was i0 months with 3 patients alive at 12, 14 and 26 months. Firm conclusions await more rigorously controlled studies and evaluation of diffe- rent agents but our results are disap- pointing with no apparent survival advan- tage when compared to similar patients who did not receive LDI.

High Dose Consolidation Chemotherapy With Autologous Blood or Bone Marrow (BND Stem Cell Rescue for Patients With Small Cell Lung Cancer (SCLC). Stiff, P.J., Koester, A.R., Lanzotti, V.J., Weidner, M.K., Eagleton, L.E. Southern Illinois University School of Medicine, Springfield, Illinois.

Eleven patients (41-71 yrs) with SCLC received a median of 3 courses of cyclo- phospham~de (CTX; 1200 mg/m-), adriamycin (60 mg/m-), and vlncristine (2 mg) every 3 weeks, followed by high dose BCNU (300 mg/m x 3d) in 6 patients, or high dose 9 BCEP (BCNU 300 mg/m ~ x 3@, CTX i000 mg/m ~ x 4d, etoposide ½00 mg/m x 5d, and cis- platinum 20 mg/m x 5d) in 5 patients. Stem cells were obtained from peripheral blood by leukophoresis as previously de- scribed (Blood 65; 230a, 1983) in 5 patients and from BM in 6 patients. Of the 6 recei- ving only BCNU, 2 had limited disease. One remains in complete remission (CR) at 32 months after diagnosis while the other relapsed at 9 months. Both also received radiation to the chest. All 4 with exten- sive disease (ED) who received BCNU alone died of their tumor at 6-13 months with no further tumor regression after the BCNU. Of the 5 (all ED) entering the BCEP study, one is too early to evaluate, 2 had a partial remission (PR) and 2 no response (NR) to initial therapy. Post transplant, 3/4 have had a CR with 1 (NR after initial therapy) in CR at 15 months, 1 in CR at 7 months, and 1 alive with disease at 14 months. The fourth patient is only 1 month

post transplant (NR after initial therapy)

but has already had a PR. No toxicity has been

noted, other than severe pancytopenia. The me- dian day to WBC > i000 and platelets > 20,000 were 6(0-34) and 30(7-46) for BCNU alone and 16(15-23) and 21(ii-30) for the BCEP combina- tion. While consolidation therapy with autolo- gous stem cell rescue and high dose BCNU alone is ineffective, the BCEP combination appears promising as a modality to improve the respon- se rate and survival of patients with SCLC. Leukophoresed blood stem cells appear to be effective as the transplant source.

VM-26, Teniposide. The Most Active Single Agent in Small Cell Lung Cacner? Bork, E., Hansen, M., Dombernowsky, P., Hansen, S.W., Pedersen A.G., Hansen,H.H. The Finsen In- stitute, Copenhagen, Denmark.

In a phase II trial VM-26 was given ~s in- travenous infusion in a dose of 60 mg/m on days 1-5 every 3 weeks to previously untreated patients with histologically confirmed SCLC. 33 patients were evaluable, of whom 28 were > 70 years. Of the remaining 6 younger patients 4 had bone marrow metastases. 25 patients had local disease, while 3 had liver metastases and one patient CNS metastases initially.

An overall response PR+CR was obtained in 30 of 33 patients (90%) with 7 CR (21%). The median duration of remission was 8+ months, range (1.1-15+ months). Toxicity was primarily hematologic with leucopenia as the only dose limiting side effect, ~ithough only 30% obtain- ed wbc counts < 2 x i0 /i initially. Beside alopecia all other side effects were negligib- le.

In conclusion no other single agent has shown comparable results in the treatment of small cell carcinoma including the closely re- lated compound VP-16. Further investigations are needed in order to confirm the present re- sults and to evaluate, if there is any signi- ficant difference in potency between VP-16 and VM-26, when the drug is given in equitoxic doses.

8, RADIOTHERAPY

Adjuvant Radiotherapy in Non-Oat-Cell Carcino- ma of t~e Lung, 1 2 Busutti ,3L., lacopino , ~., Cipolla D'Abru~zo , G., Lelli 4, G., Bragagli~ , R.B., Schi~vina , Zompatori , M., Romualdi , A., villani , S.,

2 2 6 Mastrorilli , M., Gozzetti , G., Parmeggiani , A. i. Department of Radiotherapy. 2. 2. Surgery. 3. Chemotherapy. 4. Radiology. 5. Respirology. 6. Statistics S. Orsola-Malpighi Hospital and

University of Bologna. Between 1980 and 1984 93 of the patients re-

sected for lung cancer (stage I: 24; stage II: 16; stage III: 53). were submitted to opposed ant.-post, ports adjuvant Cobalt irradiation. The mediastinum and cervical regions received 45 Gy (TDF 70). The side effects were: dyspha- gia 40%, fever 17%, cough 35%, leucopenia 25%.