[Which chemotherapy for small cell lung cancers?]

Small cell lung cancers were a clinical entity of severe prognosis until the nineteen eighties, time at which their frequent chemosensitivity was demonstrated. Around 90% of objective responses, in the case of complete response, lead to remission. Although still rare, remission depends on the ability of the treatment administered rather than on the extent of the disease itself. The use of high-dose polychemotherapeutic protocols is a fundamental requirement but exposes the patient to limiting toxicity, notably haematological. The duration of treatments should be shortened to around six cycles in the case of complete response with, whenever possible, closer periodicity. Such efficient chemotherapy can only be applied in the context of a wider strategy, notably in combination with other therapeutic means: thoracic radiotherapy of the localised forms, curative or prophylactic cranial irradiation and adjuvant medical treatments. In the case of relapse, second-line chemotherapies are proposed but their efficacy is lesser and limited in time.