[Successful treatment of refractory extensive small cell lung cancer by oral etoposide]

A 62-year-old male was admitted with chest pain and lymphadenopathy at neck for 2 weeks. His admission chest radiograph revealed a large tumor shadow, intrapulmonary metastasis and apical involvement. The patient was diagnosed as having small cell lung cancer from sputum cytology. Clinical staging was extensive disease and performance status was 1. The patient was treated by combination chemotherapy with cisplatin, adriamycin and etoposide. After 4 cycles, his chest radiograph was unchanged and he showed remarkable bone marrow suppression and superior vena cava syndrome. Thus, the initial combination chemotherapy was thought to be ineffective. Then, administration of oral etoposide (50 mg/body) was started and continued until the appearance of leukopenia (< 3,000/mm3). One month's administration of oral etoposide made the tumor shadow on his chest radiograph disappear. This disappearance was reserved for more than 4 months with oral etoposide. The average administration of oral etoposide was 2.7 day/week.