Chest
Clinical InvestigationsThe Restaging of Responding Patients With Limited Small Cell Lung Cancer: Is It Really Useful?
Section snippets
METHODS AND MATERIALS
Patients eligible for this retrospective review included all patients entered on BR.3 and BR.6. Schemata for these two trials are shown in Figure 1. The results of BR.3 and a preliminary description of BR.6 have been published.3, 4 BR.3 enrolled patients from December 1981 to October 1984 and BR.6 enrolled patients from February 1985 to December 1988.
We examined two approaches to restaging: (1) repeat scans in patients who had responded to therapy (including those with stable disease, and (2)
RESULTS
Repeated Scans in Patients Who Responded to Therapy on BR.3
Of the 298 eligible patients entered into this study, 254 met protocol response requirements (complete response, partial response, or stable disease) for repeated scanning. Of these, 64 did not have scans carried out for a variety of reasons, leaving 190 patients for the analysis. A total of five patients (2.6 percent) had scans that were positive despite other evidence suggesting response. This included one patient with a complete
DISCUSSION
An evaluation of patients on two consecutive limited SCLC studies carried out by the National Cancer Institute of Canada Clinical Trials Group clearly suggests that there is little clinical benefit associated with the performance of repeated scans in patients who are responding by other criteria. The frequency of “mixed responses” in patients who showed progression on scans while showing response in chest radiographs occurred less than 3 percent of the time in the BR.3 study. The fact that this
ACKNOWLEDGMENT:
The authors gratefully acknowledge the assistance provided by Anne Burrows Faulkner in the careful preparation of this manuscript.
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Manuscript received January 27; revision accepted July 1.