INTENSIVE CHEMORADIOTHERAPY WITH AUTOLOGOUS MARROW TRANSPLANTATION FOR SMALL CELL-CARCINOMA OF THE LUNG

Abstract

Ten patients with small cell carcinoma of the lung (7 with extensive and 3 with limited disease) underwent several courses of conventional therapy. The patients were then referred for autologous marrow transplantation, 3 during a complete response, 6 during a partial response, and 1 following no response. The pretransplantation regimen consisted of 120 mg/kg of cyclophosphamide followed by 800-1000 rad of total-body irradiation. In addition, 6 of the 7 patients with extensive disease received high-dose nitrosourea [lomustine or carmustine]. Following the infusion of cryopreserved autologous marrow, all patients achieved engraftment. Of the 3 patients without detectable tumor at the time of transplant, 2 died with tumor present and 1 survives without recurrence 27 mo. after transplantation. Of the other 7 patients, 2 had a complete tumor response; both died of interstitial pneumonitis, 1 without detectable tumor and 1 with microscopic tumor at autopsy. One of the other 5 patients had a partial response, but all died of tumor progression. The median survival from initial therapy in patients with extensive disease was 9 mo. and with limited disease was 18.5 mo.