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Randomized trial comparing induction chemotherapy versus induction chemotherapy followed by maintenance chemotherapy in small-cell lung cancer . European Lung Cancer Working Party . PURPOSE AND METHODS The European Lung Cancer Working Party ( ELCWP ) performed a randomized trial with the primary end point to determine if maintenance chemotherapy with 12 courses of etoposide ( 120 mg/m2 on days 1 and 3 ) and vindesine ( 3 mg/m2 on day 3 ) could improve progression-free survival in small-cell lung cancer ( SCLC ) patients who responded to six courses of induction chemotherapy with ifosfamide , etoposide , and an anthracycline ( doxorubicin or epirubicin ) . RESULTS Among 235 eligible patients initially registered , 91 were randomized to receive maintenance therapy , including seven patients who were no longer responding . Among 84 randomized responders , progression-free survival was significantly improved ( P = .003 ) by maintenance therapy , with median durations ( maintenance v follow-up ) of 25 versus 12 weeks after the second randomization , but survival was not significantly increased ( P = .10 ) , with median durations of 48 and 38 weeks . However , in a multi-variate analysis that took into account disease extent , maintenance therapy , Karnofsky performance status ( PS ) , and absolute dose-intensity ( ADI ) of anthracycline given during induction , limited disease ( LD ) and maintenance were found to be independent positive predictors of survival . CONCLUSION We conclude that maintenance chemotherapy in responding patients is beneficial in SCLC .
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Intervention_Physical
induction chemotherapy
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Intervention_Pharmacological
induction chemotherapy
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Intervention_Physical
maintenance chemotherapy
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Intervention_Pharmacological
etoposide
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Intervention_Pharmacological
vindesine
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Intervention_Pharmacological
induction chemotherapy
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Intervention_Pharmacological
ifosfamide
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Intervention_Pharmacological
etoposide
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Intervention_Pharmacological
anthracycline
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Intervention_Pharmacological
doxorubicin
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Intervention_Pharmacological
epirubicin
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Outcome_Mortality
progression-free survival
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Outcome_Mortality
progression-free survival
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Outcome_Mortality
survival
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Outcome_Physical
account disease extent , maintenance therapy , Karnofsky performance status ( PS ) , and absolute dose-intensity ( ADI ) of anthracycline
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Outcome_Physical
limited disease ( LD ) and maintenance
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Outcome_Mortality
survival .
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Participant_Condition
small-cell lung cancer
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Participant_Sample-size
235
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Participant_Sample-size
91
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Participant_Sample-size
seven