[Combined treatment of small cell bronchopulmonary cancer. Results of a retrospective study of 59 patients].

Fifty-nine patients with small cell bronchial tumours (36 localized, 17 diffuse, in the absence of marrow biopsy) were treated by a protocol combining chemotherapy and radiotherapy between October 1978 and October 1982. The chemotherapy consisted of three courses of Adriamycin (60 mg/m2 on day 1), Methotrexate (40 mg/m2 on day 2), Cyclophosphamide (800 mg/m2 on day 3), CCNU (60 mg/m2 on day 4). Six patients died during the first month of treatment and can not be evaluated; 53 patients completed the initial course of chemotherapy. The radiotherapy was administered after 3 courses of chemotherapy in 14 patients in complete remission and to 14 patients in incomplete remission with residual thoracic tumour. Of the 22 patients in complete remission following this combined treatment, 8 received a re-induction chemotherapy similar to the induction chemotherapy and 14 were simply followed up. The median follow-up of the survivors is 15 months. The actuarial one year survival rate of the 53 evaluable patients is 35% and the 2 year survival is 9%. There are certain hopes for the future: 1) the actuarial one year survival rate for the 22 patients in complete remission (67%) is significantly higher than that for the 31 patients who did not obtain complete remission (24%); 2) the actuarial one year survival rate for the 8 patients who received re-induction chemotherapy (87%) is significantly higher than that for the 14 patients who did not receive this treatment, although both groups were otherwise comparable. It is therefore possible that multiplication or intensification of the courses of treatment will improve the prognosis.