OUTCOME OF COMBINATION CHEMOTHERAPY IN EXTENSIVE-STAGE SMALL-CELL LUNG-CANCER - ANY TREATMENT RELATED PROGRESS

During the past two decades many different treatment regimens of combi nation chemotherapy have been applied in extensive stage small-cell lu ng cancer (SCLC). This study was carried out to identify whether these modifications have resulted in an improved overall survival for exten sive stage during the past two decades. In total, 1111 patients with e xtensive stage SCLC were included in six consecutive randomised trials in our setting from 1973 until 1992. Of these, 526 patients treated i n the early period (1973-1981) were compared with 585 patients treated in the late period (1981-1992) with respect to pretreatment prognosti c factors, staging, treatment and outcome. No change in the distributi on of prognostic factors was detected and the frequency of patients wi th extensive stage was equal in the two periods, and no difference in overall response rates and survival was observed (P = 0.49). Median su rvival in the two periods was 208 days and 215 days, respectively. No stage migration or treatment-related improved outcome was observed in extensive disease. We suggest restricting aggressive treatment to pati ents with favorable prognosis and long-term survival as a realistic ai m. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.