Combined modality studies on small cell carcinoma of the lung - current status in Japan

Sixty-two patients with small cell carcinoma in three institutes were carefully divided into limited and extensive disease categories. Median survival time of limited-disease patients was longer than those with extensive disease. In relation to the survival rate, the degree of response to initial chemotherapy was studied on 75 patients treated in our institute. The complete responders had a significantly better survival rate than the partial responders and nonresponders. Best survival was achieved by multidisciplinary treatment, including polychemotherapy, subsequent radiotherapy, and immunotherapy using BCG-CWS or Nocardia-CWS. Combination chemotherapy with concurrent small-dose radiation therapy for the purpose of intensifying the effect of chemotherapy was introduced. This method significantly improved the response rate without causing any of the side effects associated with radiotherapy. Cytomorphological studies on the correlation with better survival rates of small cell carcinoma patients were described.