LONG-TERM RESULTS OF COMBINATION CHEMOTHERAPY WITH OR WITHOUT IRRADIATION IN SMALL-CELL LUNG-CANCER - A 5-YEAR TO 11-YEAR FOLLOW-UP

Between April 1981 and December 1987, 148 patients with newly diagnose d small cell lung cancer (SCLC) were treated using combination chemoth erapy with or without thoracic irradiation and prophylactic cranial ir radiation (PCI) in a series of cooperative therapeutic trials. With a minimum follow-up of 4.7 years, 13 (9%) patients survived and were fre e of SCLC. These included 11 (15%) of 76 patients with limited disease and two (3%) of 72 patients with extensive disease. Three died withou t any evidence of SCLC (one each from second leukemia, non-small cell lung cancer, and unrelated disease). The remaining 10 (7%) patients ar e currently alive and free of SCLC beyond 4.7 years. Since late relaps e beyond 5 years is a very rare event, these patients may have been cu red. However, late toxicity of PCI must be kept in mind. Three among t he 10 patients have suffered from neuropsychologic symptoms of varying degrees in severity. Although the long-term survival rate is a benchm ark in the treatment of SCLC, modifications of therapy that may potent ially avoid such toxicities should be considered hereafter.