Abstract
During a clinical trial of duration of chemotherapy in small cell lung cancer (SCLC), 71 of 610 patients (11.6%) died in the first 3 weeks. Chemotherapy consisted of cyclophosphamide 1 g m-2 i.v. day 1, etoposide 100 mg t.d.s. orally days 1-3, vincristine 2 mg i.v. day 1. The time of death was found to be nonrandomly distributed within the first chemotherapy cycle, with a peak incidence between days 7 and 12 after chemotherapy. Patients were matched with controls who were the next cases entered into the study who did not die in the first 3 weeks. Patients dying early were more likely to have clinical hepatomegaly (P less than 0.0001), and ECOG score greater than or equal to 1 (P less than 0.00001). As a group these patients also had a higher alkaline phosphatase (P less than 0.0002), an elevated blood urea (P less than 0.00001) and a lower serum albumin (P less than 0.0001) than controls. It is probable that infection contributes to the death of these already ill patients at a time when the blood count is low. Early deaths have been noted in two other large trials using regimens including etoposide. Prophylactic antibiotics or dosage modification may prevent the early death of these high risk patients.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 24 print issues and online access
$259.00 per year
only $10.79 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Morittu, L., Earl, H., Souhami, R. et al. Patients at risk of chemotherapy-associated toxicity in small cell lung cancer. Br J Cancer 59, 801–804 (1989). https://doi.org/10.1038/bjc.1989.167
Issue Date:
DOI: https://doi.org/10.1038/bjc.1989.167
This article is cited by
-
Small cell lung cancer in the elderly: factors influencing treatment decision and effect on survival
Revista de OncologÃa (2000)
-
Early death during chemotherapy in patients with small-cell lung cancer: derivation of a prognostic index for toxic death and progression
British Journal of Cancer (1999)
-
MRC quality of life studies using a daily diary card—practical lessons learned from cancer trials
Quality of Life Research (1995)
-
Use of etoposide in patients with organ dysfunction: pharmacokinetic and pharmacodynamic considerations
Cancer Chemotherapy and Pharmacology (1994)