Combination of surgery and polychemotherapy for cure in early small-cell bronchial carcinoma.

In 1969 a cooperative randomized two arm study of surgery and adjuvant chemotherapy was started. Within three years after the operation the polychemotherapy was given intermittently using a combination of cyclophosphamid + 5-FU + MTX + vinblastin. From a total of 859 patients operated for cure preliminary evaluations per 1.3.1981 found 53 patients with small cell type carcinomas. An increase of the 3-year survival rate of 13 per cent shows a clear positive therapeutic effect. This also demonstrates the importance of surgery even on small cell bronchogenic carcinoma by decreasing the tumor burden. To evaluate wether or not the number of long-term survivors can be increased furthermore, a new randomized trial was started in 1979 to compare the polychemotherapy used with a new designed intermittent polychemotherapy-schedule using alternating cyclophosphamid + CCNU + MTX, there after cyclophosphamid + adriamycin + vincristin and there after ifosfamid + VP-16; then radiation therapy and there after repeating the whole sequence.