Patient progress modelling for small cell lung cancer

This paper describes the use of a mathematical technique called Patient Progress Modelling to reassess the results of an MRC trial on small cell lung cancer. The trial concerned patients treated initially with chemotherapy and radiotherapy and achieving at least a partial response. It compared the effects of giving maintenance chemotherapy with those of giving no maintenance therapy. The results of the MRC trial established that there was no significant survival difference between the two groups overall. However, it was observed that amongst patients achieving a complete response, those receiving maintenance chemotherapy had a small survival time advantage. The analysis described here suggests the hypothesis that this can be accounted for by differences in the pattern of deaths after relapse. There appeared to be little difference in the disease-free period.