[Sequential or alternate chemo-radiotherapy in the treatment of advanced XXXX . Results of a randomized study].

@entity1 @entity135 @entity137 @entity5 @entity33 @entity1732 @entity1499 @entity5713
Between 1983 and 1986, a multicenter randomized study was conducted to compare a sequential program of induction chemotherapy (CT) followed by radiotherapy (RT), Arm A, with an alternation of 4 cycles of CT with 3 courses of RT (20 Gy/10 fractions up to a total dose of 60 Gy), Arm B, in advanced @entity135 @entity1 . The same CT (VBM: @entity5713 , @entity1732 , @entity1499 ) was used on both arms; one hundred and sixteen @entity1 (pts) entered the study, 55 in Arm A, 61 in Arm B. Fourty-five pts had stage III and 71 stage IV @entity5 . The two arms are fully comparable. Up to October 1987, 116 pts are evaluable for survival, while 112 are evaluable for @entity137 and 105 for response. In 21 @entity1 (10 in Arm A, 11 in B) the association CT-RT was followed by surgery. Response analysis shows 14 complete responses in Arm A and 30 in Arm B (p less than or equal to 0.03). The median disease-free survival and median overall survival are also statistically different, with an advantage for Arm B (33 vs 22 weeks, p less than or equal to 0.0007, and 59 vs 38 weeks, p less than 0.03 respectively). The actuarial overall survival of complete responders at 50 months is 43% (B) and 21% (A). @entity137 (mainly stage III-IV @entity33 ) is superior in Arm B (30% vs 4%). Our experience demonstrates the advantages of alternate over sequential CT-RT. A comparison of this cyclic association with RT alone is in progress.
