[Dose intensity of chemotherapy in small-cell lung carcinoma. Review of comparative studies]

Chemotherapy improves survival and achieves an impressive response rate, and, eventually, a percentage of long-term survivors in small-cell lung cancer. A possible way to a further improvement of these therapeutic outcomes is increasing chemotherapy dose-intensity. However, randomised comparative trials only show a slight improvement of results, with small clinical relevance. Prophylactic use of colony-stimulating factors decrease the incidence of neutropenia and neutropenic fever in comparative studies when an exceedingly myelotoxic chemotherapy regimen is used. And they also permit a little increase in chemotherapy dose-intensity without significant antineoplastic effect and almost no impact in overall survival. Nowadays, the administration of higher doses of chemotherapy in small-cell lung cancer still remains investigational in oncology.