[Progress and obstacles in chemotherapy and combined modality treatment of small cell lung cancer].

In order to assess the development of treatment of small cell lung cancer (SCLC), we analyzed a total of 183 patients who had been entered into our protocol studies since 1976. Between 1976 and 1981, 39 patients (20 LD and 19 ED) received COMP, a 4-drug combination of cyclophosphamide (CTX), vincristine (VCR), methotrexate and procarbazine. During the period, chest irradiation (RT) was optimal for those with LD. Between 1981 and 1986, 112 patients (56 each of LD and ED) were treated with a cyclic alternating chemotherapy (CT) of COMP and VAN, a 3-drug combination of etoposide (VP-16), adriamycin (ADM) and nimustine. In this study, we randomized patients with LD either to receive CT alone or CT plus RT of 40 Gy to assess the role of RT in the treatment of LD. Thereafter, a pilot study of CAV-PVP hybrid CT has been conducted in 32 patients (16 each of LD and ED), in which CTX, ADM and VCR were given on day 1 (CAV), and cisplatin on day 8 and VP-16 on days 8 and 9 (PVP). RT was administered mandatory to LD in this study.(ABSTRACT TRUNCATED AT 250 WORDS)