Lung abscess in small cell carcinoma of the lung during chemotherapy and corticosteroids: an analysis of 276 consecutive patients.

Two hundred and seventy-six consecutive patients with small cell carcinoma of the lung (SCCL) treated with combination chemotherapy and in 79 cases with "high-dose" steroids (greater than 40 mg of prednisone per day) were reviewed for the presence of lung abscess. This was diagnosed in 17 patients, in 4 (1.5%) at the time of their malignant diagnosis and 13 (4.9%) during chemotherapy. Five of 79 patients receiving "high-dose" glucocorticoid therapy and 8 of 184 patients not receiving steroids developed lung abscess (no statistical difference, P greater than 0.05). "High-dose" steroids do not facilitate the development of lung abscess. Eleven patients presented with a lung abscess within a month of initiation of chemotherapy. Median survival of these patients was 182 days and not significantly different from a median survival of 224 days (P greater than 0.05) observed in 31 compatible patients without lung abscess. Lung abscess per se in patients with SCCL should not prevent the use of intensive combination chemotherapy and "high-dose" steroid therapy.