This clinical trial, which was sponsored by the National Cancer Institute in Canada, was designed to determine whether radiation therapy administered concurrently with the second cycle of chemotherapy could improve the overall survival of patients with limited stage small cell lung cancer compared to administration of radiation therapy concurrent with the last cycle of chemotherapy. Patients received a total of 6 cycles of chemotherapy treatment and patients without evidence of progression of their cancer at the completion of therapy were treated with prophylactic central nervous system radiation.

There were no significant differences in the tolerability of delivering radiation therapy early versus late concurrent with chemotherapy administration. These 2 treatment approaches were directly compared and the patients treated with early radiation survived an average of 21 months compared to 16 months for patients treated with late radiation. More importantly, the 5-year survival rates for patients treated with early radiation were nearly double those for patients treated with late radiation. Patients treated with early radiation were also significantly less likely to develop brain metastases. The results of this and other clinical trials have led to a standard practice of administering radiation concurrent with early cycles of chemotherapy in overall multi-modality treatment approaches to limited disease small cell lung cancer. (Journal of Clinical Oncology, Vol 11, pp 336-344, 1993)

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