Combination chemotherapy and radiation therapy of undifferentiated small cell bronchogenic carcinoma

We reviewed 76 cases of small cell bronchogenic carcinoma seen at the University of South Florida Medical Center. One third of the 55 patients who have subsequently died did so within one month of diagnosis. Thirty-five patients were treated with cyclophosphamide, adriamycin, vincristine, and radiation therapy including prophylactic cranial irradiation. Of these 35 patients, 40% demonstrated a complete remission for a total objective response rate of 63%. The projected median survival of patients referred for study is 14 months. Improved survival was found in patients less than 60 years of age, with limited disease, who responded to treatment and in whom there were no violations of protocol. Patients treated with combination therapy appear to survive longer than untreated patients and those treated with radiation therapy alone. Toxicity was tolerable and there were no deaths related to treatment. Small cell bronchogenic carcinoma is a rapidly progressive systemic disease responsive to multimodality therapy with long-term survival in some patients.