An elderly case of small cell lung cancer showing complete response by oral administration of etoposide

An 87-year-old female was admitted with left chest pain and dyspnea in January 1989. The chest X-ray film revealed complete atelectasis of the left lung. Bronchoscopic observation revealed a tumor which was bleeding easily at left main bronchus. Cytological findings of the bronchial aspirates showed small cell lung cancer. Because she was old and had some complications, she was difficult to treat by standard combination chemotherapy. Only etoposide at 150 mg/day was administered orally for 3 days (first course). After the first course the whole lung atelectasis improved; and after the second course (etoposide at 150 mg/day for 4 days) the tumor of the left main bronchus disappeared under endoscopic examination. Malignant cells were not detected in the bronchial aspirates and biopsy specimens. No severe side effect except for alopecia and mild gastrointestinal symptoms such as nausea and vomiting was noted. Myelosuppression was not evident. This case suggested that etoposide administered orally is useful in the treatment of small cell lung cancer especially in elderly patients with complications.