["State of the art" of chemotherapy for lung cancer]

This paper reviews the recent clinical trials of chemotherapy and combined modality therapy in small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). 1) A meta-analysis has shown that survival is prolonged when radiotherapy is used in combination with chemotherapy in the treatment of limited-stage SCLC. A randomized trial comparing early radiotherapy (RT) with late RT has reported the survival advantage in the early RT. Recent pilot trials employing accelerated hyperfractionated RT with concurrent cisplatin (CDDP) and etoposide have shown encouraging survival results. 2) The approach to increasing dose intensity has been attempted in the treatment of extensive-stage (ES) SCLC. The most common approach is weekly chemotherapy. Results of pilot studies using this approach have shown the relatively high rate of complete response with an average of 36% and longer survival with a median of more than 10 months in ES-SCLC. 3) Combined modality treatment employing CDDP-containing chemotherapy or CDDP alone and radiotherapy have produced positive results in the treatment of locally advanced stage III A or III B NSCLC. In conclusion, despite the advances of treatment, the cure rate remains quite low in lung cancer. Further investigations are needed to improve the outcome with this disease.