[Teniposide and cisplatin compared with etoposide and cisplatin for treatment of small cell lung cancer].

BACKGROUND & OBJECTIVE: EP regimen[etoposide (VP-16) + cisplatin (DDP)] is a standard regimen for treatment of small cell lung cancer (SCLC), but the cure rate is still low. Teniposide (VM-26) is highly active single agent for SCLC as VP-16, and penetratable through blood-brain barrier. This clinical trial was designed to compare the efficacy and toxicity of teniposide plus cisplatin (VM-26 + DDP) regimen and EP regimen in treatment of SCLC, and the possible role of VM-26 on prevention of brain metastasis of SCLC.

METHODS

A total of 70 previously untreated SCLC patients without brain metastasis were included; 34 patients received VM-26 + DDP and 36 patients received EP. The characteristics of patients were comparable according to chi 2 test.

RESULTS

The overall response rate-was 76.5% for VM-26 + DDP group with 12 complete response (CR) and 14 partial response (PR), and 69.4% in the EP group with 12 CR and 13 PR (P = 0.595). The median duration of survival was 10.4 months for VM-26 + DDP group versus 9.8 months for EP group (P > 0.05). The 1, 2, and 5-year survival rates were 35.3%, 14.7%, 8.8% in the VM-26 + DDP group; and 38.9%, 13.9%, 8.3% in the EP group (P > 0.05, without statistical difference). The rate of brain metastasis was 5.9% for VM-26 + DDP group and 19.4% for EP group (P = 0.027, with statistical difference). The main toxicity was mylosuppression (I-II); there was no significant difference between the two groups (P > 0.05).

CONCLUSION

VM-26 + DDP is a highly active regimen for treatment of SCLC; there is no difference in the effectiveness and toxicity versus EP regimen; VM-26 is possibly effective in prevention of brain metastasis in SCLC patients.