Combination chemotherapy and radiation therapy for small cell carcinoma of the lung

: From January, 1982 to March, 1983, patients with small cell carcinoma of the lung were treated at Kyushu Cancer Center. Eleven patients received combination chemotherapy-radiotherapy and one patient chemotherapy alone. The chemotherapy regimen consisted of cyclophosphamide, adriamycin and vincristine which was repeated every 4 weeks for as long as possible. Radiotherapy was administered to the primary lesion and mediastinum following 2 cycles of induction chemotherapy. The overall response rate after receiving 2 cycles of chemotherapy was 75% with 4 complete (33%) and 5 partial responses (42%). After radiotherapy, response increased to 100% with 8 complete (73%) and 3 partial responses (27%). Complete response occurred in 6 of the 7 patients with limited disease and 2 of the 5 patients with extensive disease. Overall survival rate was 73% at 1 year, 36% at 2 years and 12% at 3 years with a median survival time of 21 months. Survival was better in patients with limited disease than in those with extensive disease (median survival time, 21.5 months vs. 14 months). In the 3-Year follow-up period, all patients had recurrences consisting of 4 distant, 2 local and 5 both. Myelosuppression was mild to moderate and there were no deaths related to the side effects of treatment.