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Is adjuvant treatment with vinblastine effective in reducing the occurrence of distant metastasis in limited squamous cell lung cancer? A randomized study

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Abstract

In order to study the usefulness of treatment with vinblastine (VLB) in the prevention of cancer metastasis in squamous cell lung cancer, 50 patients with locoregional disease were randomized to receive either locoregional RT alone (group A) or a weekly intravenous bolus injection of VLB (6 mg/m2) concurrently with and after locoregional radiotherapy (RT) (55 Gy in 6 weeks) until the appearance of metastases (group B). Neither the incidence of death with metastases, metastasis-free survival (MFS) nor overall survival (S) were significantly affected by treatment with the drug. However, due to the limited number of patients in each group, the power of the statistical test was such to allow only the detection of differences in MFS and S to or more than 80 per cent at theP=0.05 level. Local tumor response was significantly superior in group B (P<0.05). Acute toxicity (dysphagia, myelosuppression) during RT was significantly worse in group B. During long-term therapy with VLB, mild polyneuropathy developed in the majority of patients in group B. Furthermore, seven patients discontinued treatment with VLB during maintenance due to compliance (4) and excessive neurotoxicity (3).

This treatment schedule with VLB is not recommended for patients with locoregional squamous cell lung cancer as significant toxicity is present during and after RT and significant increase in MFS and S is lacking. Because of an apparent increase in local response, the combination of VLB and RT merits further investigation in those tumors where local tumor control is crucial.

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Author notes

  1. D. C. Schallier

    Present address: Bristol Myers Belgium, Terhulpsesteenweg 185 187, 1170, Brussels, Belgium

Authors and Affiliations

  1. Oncologic Centre V.U.B., Department of Medical Oncology, Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    D. C. Schallier, J. L. De Greve, S. P. Van Belle & G. J. De Wasch

  2. Oncologic Centre V.U.B., Department of Radiotherapy, Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    W. J. De Neve & G. A. Storme

  3. Department of Internal Medicine and Pneumology, St Lucas Hospitaal, Assebroek, Brugge, Belgium

    G. Dotremont

Authors
  1. D. C. Schallier
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  2. W. J. De Neve
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  3. J. L. De Greve
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  4. S. P. Van Belle
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  5. G. J. De Wasch
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  6. G. Dotremont
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  7. G. A. Storme
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Schallier, D.C., De Neve, W.J., De Greve, J.L. et al. Is adjuvant treatment with vinblastine effective in reducing the occurrence of distant metastasis in limited squamous cell lung cancer? A randomized study. Clin Exp Metast 6, 39–48 (1988). https://doi.org/10.1007/BF01580405

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  • DOI: https://doi.org/10.1007/BF01580405

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