Small-cell carcinoma of lung: reinduction therapy after late relapse

Some patients with small-cell carcinoma of lung can be expected to achieve long-term disease-free survival. However, relapses may occur even after 2 years. Information on the treatment of these patients is sparse, although response rates to "salvage" therapy in patients with progressive disease while receiving treatment are poor. We report six patients who had relapses after more than 2 years in complete remission. Five patients were retreated with chemotherapy including some or all of the drugs in the initial treatment, and four had responses with a median duration of 10 months (range, 2 to 18 months). Thus retreatment with chemotherapy similar to the initial treatment can occasionally achieve second responses persisting up to 1 year or longer. The high incidence of patients who have relapses after 2 years confirms previous data on relatively slow growth rates in small-cell carcinoma.