Effective combination chemotherapy of carboplatin and paclitaxel in the treatment of a recurrent small-cell lung cancer patient.

Although small-cell lung cancer (SCLC) is a highly chemosensitive tumor, most patients relapse and have a poor prognosis. Relapsed patients become candidates for second-line or salvage chemotherapy. We report an effective case of weekly chemotherapy with carboplatin and paclitaxel in the treatment of a recurrent SCLC patient. A 58-year-old man diagnosed as SCLC received four courses of concurrent chemoradiotherapy with etoposide and cisplatin, and achieved a complete response. Solitary pulmonary metastasis was detected 9 months after chemoradiotherapy. He received second-line chemotherapy with irinotecan and cisplatin, but the mass remained as stable disease. Thus, thoracotomy was performed for the resection of the mass, and histological examination revealed a recurrence of SCLC. Pleural dissemination and multiple pulmonary metastases were detected, and he received third-line chemotherapy with amrubicin. However, there was evidence of recurrence, and he was given fourth-line chemotherapy with topotecan. Marked growth of pleural dissemination caused severe back pain, hence fifth-line chemotherapy using paclitaxel (70 mg/m(2); days 1, 8, and 15) and carboplatin (AUC 2; days 1, 8, and 15) was initiated. After three courses of chemotherapy, a good response was confirmed. The toxicity of chemotherapy was mild, and his symptoms including back pain completely disappeared. The patient has been alive now for 42 months after the initial therapy. Our result suggests that weekly chemotherapy with carboplatin and paclitaxel could be a well-tolerated and effective regimen for salvage chemotherapy of recurrent SCLC.