EARLY ALTERNATING CHEMOTHERAPY AND RADIOTHERAPY SCHEDULE IN LIMITED DISEASE STAGE SMALL-CELL LUNG-CANCER

44 patients with limited small cell lung cancer were treated with six cycles of chemotherapy (cisplatinum 60 mg/m(2) day 1, doxorubicin 40 m g/m(2) day 1, etoposide 100 mg/m(2) days 1-3) alternating with three c ourses of mediastinal irradiation, the first one starting 7 days after the first day of chemotherapy. A total dose of 55 Gy was delivered. P rophylactic cranial irradiation (30 Gy after the third cycle of chemot herapy) was left to the physician's discretion. 4 patients had radical surgery before combined modality treatment. 29 patients finished the scheduled program. The complete response rate (bronchoscopically confi rmed) was 25.6% after two cycles of chemotherapy and 41% at the end of treatment. Median survival time was 17.2 months, with an estimated su rvival of 32% at 2 years. Main toxicity was haematological with one ea rly toxic death and six premature interruptions of treatment. We concl ude that this treatment modality is feasible and efficacious. Prospect ive studies comparing chemotherapy with alternating or concurrent earl y radiotherapy schedules in limited disease small cell lung cancer are needed to determine the best treatment modality.