[Results of combined antineoplastic polychemo- and radiotherapy in small cell bronchial cancer and implications for...

It is reported on 60 patients (48 males and 12 females) who since 1977 have undergone a combined chemotherapy with 5-fluorouracil, vincristine and vinblastine , respectively, methotrexate and cyclophosphamide. After 1--2 initial cycles simultaneously to the chemotherapy a radiotherapy was performed under telecobalt conditions. In the patients with a limited disease 83% full remissions and 17% partial remissions were achieved. In those cases in which an extensive disease was present 19% full remissions and 65% partial remissions could be achieved. A tumour progression was observed in 16%. The mean survival time in complete remissions is 15.5 months and in partial remissions 10.8 months. Three patients are to be estimated as long-term survivors. Thus, the results are not more unfavourable than in other therapy strategies. Despite the progress in the past these results of the treatment cannot satisfy. Better results are possible by the application of cisplatin and etoposide, by which means, however, the danger of the threatening side-effects of the therapy increases. The strategy of treatment favoured nowadays provides an aggressive induction polychemotherapy, which at an interval of 4 weeks is followed by the loco-regional radiotherapy. Following this a chemotherapy is again performed. With regard to them there are no unique conceptions. Polychemotherapy regimes with not cross-resistant cytostatics administered alternatingly give theoretically the prerequisites for more favourable results, which, however, need stil confirmation in clinical oncology. Apart from other questions it is above all necessary to clarify the kind of therapy after full remission.