Waseem Saeed, Farrukh Saeed, Arshad Naseem, Amir Iftikhar Malik.
Small Cell Lung Cancer Chemotherapy: A nine year experience of `London Lung Cancer Group Protocol.
Pak Armed Forces Med J Jan ;53(1):38-43.

Lung cancer is the leading cause of cancer related deaths. Small cell lung cancer is found in 20-25% cases. Chemotherapy is cornerstone of treatment. With appropriate therapy majority of patients with small cell lung cancer can expect to achieve remission and a significant prolongation of life. Our objective was to evaluate the `London Lung Cancer Group Protocol` for chemotherapy of Small Cell Lung Carcinoma being followed in our unit. This hospital based prospective study was carried out in Pulmonology Department of Military hospital, Rawalpindi between May 1989 to May 1998. In total 484 cases of bronchogenic carcinoma were diagnosed. Sixty eight had small cell cancer while 416 had non small cell lung cancer. 39 patients who fulfilled the inclusion criteria were subjected to thorough clinical examination and detailed investigations to ascertain the stage of the disease. The patients were then divided into groups according to the staging. Fifteen patients (38.4%) with limited disease were in Group I, while 24 patients (61.5%) with extensive stage disease and good prognosis were in Group II. Most patients (43.5%) were between age 51-60 years, (38.4%) 61-65 years of age, (12.8%) were 41-50 years and only 5.1% patients were between 31-48 years. Commonest presenting symptom (92.3%) was cough, while 58.9 % had hemoptysis, 48.7% severe dyspnoea, 20.5% superior venacaval obstruction and 38.4% chest pain. The most common side effect of chemotherapy was alopecia (61.5%) followed by GI symptoms other than vomiting (30.7%). One patient had cardiac decompensation and two had myelosupression. In total 30 cases (76.9%) completed chemotherapy. Treatment was abandoned in five cases (12.8%) due to various reasons while 4 were lost to follow up. Out of the 30 patients who completed chemotherapy 60% were complete responders while 40% were partial responders. Symptoms regressed considerably after treatment. Median survival was fifteen months in group I and nine months in group II. We concluded that `London Lung Cancer Group Protocol being followed at our unit had good response rate, was safe and cost effective and had minimal side effects.

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