TREATMENT OF SMALL CELL-CARCINOMA OF THE LUNG

  • 1 January 1981
    • journal article
    • review article
    • Vol. 62  (5) , 315-331
Abstract
Current strategies for treatment of small cell carcinoma of the [human] lung are based on the concept of the disease as a systemic condition, requiring systemic treatment. Small cell carcinoma is considerably more sensitive to anticancer drugs than other bronchogenic neoplasms. The most widely used agents are cyclophosphamide, adriamycin, vincristine, CCNU [1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea], methotrexate and VP 16-213 [vepeside]. The superiority of combination chemotherapy over single drug treatment has been documented in prospective randomized trials. With suitable drug regimens, partial or complete remissions can be achieved in 80-90% of untreated cases, resulting in 3- to 5-fold prolongation of median survival. Radiotherapy may improve control of intrathoracic disease and reduce the incidence of cerebral metastases, but this treatment does not increased median survival. In spite of impressive initial responses, long-term results are disappointing, with a 2 yr disease-free survival rate of .apprx. 5-10%. Improvement of treatment results may be expected from the use of sequential combination chemotherapy with drugs administered at maximally tolerated doses. A high intensity of treatment calls for increased attention to supportive measures against infections and other complications. The ultimate role of surgery, brain and/or chest irradiation and immunotherapy as adjuvants to chemotherapy remain to be defined.