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document
Duration of chemotherapy in small cell lung cancer : a Cancer Research Campaign trial . A total of 610 patients with small cell lung cancer were entered into a randomised trial designed to assess the effect of duration of initial chemotherapy on survival . Patients were randomised to receive either four or eight courses of cytotoxic chemotherapy with cyclophosphamide , vincristine and etoposide and also randomised to receive , on disease progression , either second line chemotherapy ( methotrexate and doxorubicin ) or symptomatic treatment only . In the whole study 196 ( 32.1 % ) had limited disease and 414 ( 67.9 % ) extensive disease . During initial chemotherapy the response rate ( complete and partial responses ) after four courses of treatment was 61 % with no significant increase in patients receiving eight courses ( 63 % ) . In those randomised to receive relapse chemotherapy the response rate was improved slightly for those who had originally received four courses of chemotherapy ( 25.6 % ) over those receiving eight ( 18.7 % ) . The overall results show that of the four possible treatment randomizations , four courses of chemotherapy alone is inferior in terms of overall survival ( 30 weeks median survival ) to the other three treatment options ( 39 weeks median survival , P less than 0.01 ) . In patients responding to initial chemotherapy the disadvantage of four courses of chemotherapy alone was apparent ( median survival of 40 weeks versus 49 weeks , P = 0.003 ) but not if drug treatment was given on relapse . The study shows that limiting treatment to four courses of chemotherapy alone is associated with inferior survival , but this is not the case if chemotherapy is given at relapse .
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Intervention_Pharmacological
cytotoxic chemotherapy with cyclophosphamide , vincristine and etoposide
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Intervention_Pharmacological
second line chemotherapy ( methotrexate and doxorubicin ) or symptomatic treatment only
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Outcome_Other
Duration of chemotherapy
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Outcome_Other
response rate ( complete and partial responses )
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Outcome_Other
response rate