Table 12 Randomized Controlled Trials of Glucocorticoids in Lung Cancer

Wolf et al [41, 42], 1960

lung carcinoma not amenable to surgery or radiation therapy; distribution of the 4 tumor types (squamous, small cell, adenocarcinoma, large cell) between treatment groups did not statistically differ

Nitrogen mustard 0. 4 mg/kg IV days 1 and 42 (80/70) vs. testosterone propionate 100 mg IM three times weekly (106/99) vs. cortisone 100 mg po daily (86/78) vs. progesterone 2 mg po daily (91/83) vs. diethylstilbestrol 10 mg po daily (89/82) vs. placebo po daily (88/84); all treatments (except for nitrogen mustard) for 12 weeks followed by 8 week taper for oral treatments

4

median survival (days) of 121 vs. 78 vs. 56 vs. 60 vs. 75 vs. 93

Macbeth et al [10], 1994

nonsmall cell and small cell lung cancer

76/72 to either megestrol acetate 480 mg/m² or prednisolone 15 mg/m² for 8 weeks; no radiation with a curative intent or chemotherapy given

2

survival worse in the megestrol acetate arm (p = 0.02)

Thatcher et al [34], 1982

metastatic nonsmall cell and small cell lung cancer; no previous chemotherapy or steroids

Cyclophosphamide IV 1.5 g/m², 2.5 g/m², 3.5 g/m² each separated by 3 weeks (28/28, 16 SCLC) vs. same + prednisolone 100 mg/m² orally on day of and day after each chemotherapy (29/29, 16 SCLC)

2

response rates of 57% vs. 24%, median duration of response (weeks) of 15 vs. 11 (p > 0.05), median survival (weeks) of 24 vs. 14 (p = 0.004)

Leggas et al [89], 2005

untreated Stage lV NSCLC

4 cycles of carboplatin AUC 5.5 day 1 and gemcitabine 1000 mg/m² days 1 and 8 every 21 days; 4 days prior to and the day of each chemotherapy treatment in courses 2-4, dexamethasone 16 mg bid (NR/12) vs. 8 mg bid (NR/12) vs none (NR/6)

8 PR vs. 7 PR vs. 2 PR