[Phase III therapy study in patients with small cell bronchial cancer]

In a prospective randomized study 150 patients with small cell lung carcinoma (80 cases with extended, 70 cases with limited disease) received either cisplatin + etoposide (DDP/VP) or cyclophosphamide + etoposide (cyclo/VP) as induction chemotherapy. Patients were crossed over when less than complete remission was achieved. Treatment failures received a salvage regimen with adriamycin + vindesine (ADM/VDS). Remission rates (complete + partial remissions) achieved with DDP/VP were 87.4% (40.6% + 46.8%) in limited disease and 72.2% (10.1% + 62.1%) in extended disease; response rates seen following cyclo/VP were 78.8% (31.5% + 47.3%) in limited and 51.0% (6.9% + 44.1%) in extended disease. Median survival time for patients in complete remission was 12.0 months following DDP/VP and 14 months following cyclo/VP; for patients in partial remission 10.0 and 9.0 months, respectively. The analysis of the treatment results shows an equal effectivity of both induction regimes which, however, seem to be largely cross resistant. DDP/VP probably causes more stable longtime remissions. The salvage regimen ADM/VDS was ineffective. The results achieved with this rather complex therapeutic strategy are not superior to those seen with simpler regimes.