Comparison of carboplatin/etoposide/vincristine with cisplatin/etoposide as combination chemotherapy for small cell lung cancer.

We compared the efficacy and toxicity of the CEV regimen (carboplatin at 300 mg/m2 on day 1, etoposide at 100 mg/body on days 1 to 3, and vincristine at 1 mg/m2 on days 1 and 8) with the PVP regimen (cisplatin at 80 mg/m2 on day 1 and etoposide at 100 mg/body on days 1 to 3) in patients with untreated small cell lung cancer (SCLC). Of the 13 patients treated with the PVP regimen, two achieved complete response (CR, 15.4%) and eight partial response (RP, 61.5%). Of the 15 evaluable patients treated with the CEV regimen, one achieved CR (6.7%) and 13 PR (86.7%). Thus, there was no significant difference in response rate between the PVP (76.9%) and CEV (93.3%) regimens. There was also no significant difference in response duration [PVP, 756 +/- 903 (mean +/- SD) days vs. CEV, 318 +/- 159 days] and median survival time (PVP, 472 days, vs. CEV, 471 days). The number of days hospitalized divided by the duration of chemotherapy was shorter with the CEV regimen, but this difference was not statistically significant. Severe leukopenia (< 2,000/microliter) occurred in 15.4% of PVP patients and 31.3% of CEV patients. Severe thrombocytopenia (< 50,000/microliter) occurred in only one patient in this study. In conclusion, the CEV regimen demonstrated a response rate and median survival time comparable to the PVP regimen, although the response time was short. The CEV regimen had the advantage of lower toxicity and ease of outpatient administration. Thus, the CEV regimen is a useful outpatient induction chemotherapy for SCLC.