Small-Cell Carcinoma of the Lung: Combined Chemotherapy and Radiation

Abstract

Chemotherapy (doxorubicin, cyclophosphamide and vincristine) was given in a sequential fashion with radiation of the primary tumor and brain to 358 patients with small-cell lung carcinoma (extensive disease in 250, limited in 108). Complete regression of tumor was obtained in 14% of patients with extensive disease and 41% of patients with limited disease, and complete or partial response in 57% and 75%, respectively. Median survival was 26 wk for patients with extensive disease and 52 wk for those with limited disease. Response duration was longer for patients in complete remission; 1/3 had disease-free survival > 1 yr. Toxicity from the combined treatment modalities was no greater than expected from the components given separately: fatal in 3.9% and life-threatening but reversible in 8.4% of patients. Whole-brain radiation was effective in preventing isolated relapse at that site. This therapy appears both feasible and effective, with acceptable risks and some benefit to most patients.