CONSOLIDATIVE THORACIC RADIOTHERAPY AND PROPHYLACTIC CRANIAL IRRADIATION IN LIMITED DISEASE SMALL-CELL LUNG-CANCER

Between 1983 and 1990, 128 patients with limited disease small cell lu ng cancer (SCLC) received consolidative thoracic irradiation after rea ching a complete (CR) or partial response (PR) to combination chemothe rapy. Patients in CR (n = 85) received 35-36 Gy in 12-14 fractions and patients in PR (n = 43) 24-30 Gy in 3-6 fractions. Until 1989, prophy lactic cranial irradiation (PCI) was given to patients in CR. There wa s no significant difference in survival between the CR and PR group. H owever, patients with residual tumor detected by radiology or bronchos copy or cyto-/histology had significantly longer survival than those w ith residual tumor demonstrated by more than one of the above methods of investigation. Overall, local progression was observed in 22% and d istant dissemination in 63% of patients. The rate of brain metastases was significantly lower in patients treated with methotrexate and nitr osurea containing schedules and PCI, compared to those who were treate d with other schedules (irrespective of PCI).