Limited small-cell lung-carcinoma - high complete response rate and survival with short intensive chemotherapy and extensive irradiation - results of a pilot-study.

Sixteen patients with limited small-cell lung carcinoma (SCLC) were treated with three monthly courses of intensive chemotherapy (cisplatin: 40 mg/m2/day (D), D1, D2 and D3; cyclophosphamide: 750 mg/m2/D, D4 and D5; adriamycin: 50 mg/m2/D, D5; vindesine: 2 mg/m2/D, D1 and D5; etoposide: 100 mg/m2/D, D1, D2 and D3; methylprednisolone: 120 mg/m2/D, D1 to D5). Thoracic and prophylactic brain plus spinal area irradiations were performed after completion of the third chemotherapy cycle. The complete response rate was 100%. Of these 16 patients, 7 experienced a relapse from 5 to 31 months after completion of treatment. The three-year survival rate was 54%. The main toxicities were hematological (neutropenia and thrombocytopenia) and digestive. We conclude from this pilot study that intensive five-drug chemotherapy is a highly effective regimen for limited SCLC. This intensive chemotherapy regimen and extensive irradiation is feasible without major toxicity. This type of intensive combined-modality program deserves further study to definitely establish its long-term efficacy in localized SCLC.