Small-cell carcinoma of the lung: attempt to remedy causes of past therapeutic failure.

A regimen of intensive, cyclic chemotherapy (cyclophosphamide, vincristine, doxorubicin administered concurrently with radiotherapy of bulk disease plus prophylactic whole-brain irradiation has been investigated for small-cell carcinoma of the lung. Treatment was completed in 12 weeks, after which patients were observed without maintenance therapy. Complete clinical remissions were noted in twenty of twenty-one patients with unresectable tumours, 10 of whom had distant extrathoracic spread upon admission. Survival has been prolonged and nine of the eleven patients with regional disease (mediastinal adenopathy with or without pleural effusion and/or supraclavicular nodes) have remained clinically disease-free for 6-14 months (median 10) and have resumed normal activities.