Sequential combination chemotherapy and radiotherapy in locally advanced non-small cell carcinoma of the bronchus

The feasibility, effectiveness and toxicity of a new four drug intensive combination chemotherapy regime has been assessed in 36 patients with inoperable non-small cell lung cancer. Three cycles of adriamycin, vindesine, ifosfamide and cisplatin were given to 36 patients followed by sequential radiotherapy to 25 patients. The overall response rate to chemotherapy was 33%, and median progression free interval was 6 months. Median survival was 8.5 months. Grade 4 WHO neutropenia was seen in 12 patients, there were three episodes of neutropenic fever and one death in which toxicity may have been contributory. Radiotherapy was not associated with serious toxicity. This study demonstrates that a significant response rate can be achieved with short intensive chemotherapy in unresectable non-small cell lung cancer and that it is feasible to combine this with radiotherapy.