Cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide in patients with small cell lung cancer.

Fifty-seven patients with small cell lung cancer were treated with cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide. Seven patients were withdrawn because of drug toxicity. Of 50 evaluable patients 21 had limited and 29 extensive disease of whom 19 and 21 respectively achieved an objective response. Seven patients survived for longer than 2 years of whom 5 remained alive and tumour free 121-167 weeks from the start of treatment. Patients with limited disease and a complete response had a median survival of 72 weeks and the median survival of the whole group was 43 weeks. Seven out of 22 (32%) of patients who obtained a complete response relapsed and died with solitary evidence of cerebral metastases. This indicates the need for reassessment of the role of prophylactic cranial irradiation in patients achieving a complete response with effective systemic chemotherapy.