The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 292-296, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Combined therapy for small cell undifferentiated carcinoma of the lung
I Mandelbaum, SD Williams, NB Hornback, BT Joe and LH Einhorn
Fifty-eight patients with small cell lung cancer were treated from
September, 1974, to March, 1976, with combined chemotherapy and
radiotherapy. Surgical resection of the lung lesion was performed in three
patients, and a number of surgical diagnostic methods were carried out in
the remaining patients with unresectable of disseminated lesions. Nineteen
patients were from the Veterans Administration Hospital and 39 from Indiana
University Medical Center. The median Karnofsky performance status was 60.
Thirty-nine patients had extensive disease, and 19 had disease limited to
the chest and supraclavicular area. All patients received chest
radiotherapy and prophylactic whole brain radiation. Adriamycin,
cyclophosphamide, and vincristine were given on day 1 and continued every 3
weeks. There were 27 (48 percent) partial remissions of a median duration
of 26 weeks. There were 25 patients (43 percent) with complete remission.
The median survival for the entire group was 51 weeks. Six of 58 patients
(10 percent) are alive and disease free from 24 to 38 months after
treatment. Six of 19 patients with limited disease (32 percent) are
presently alive and disease free. This includes one patient in whom
surgical resection was performed. Combined therapy influences favorably the
prognosis of small cell cancer of the ling, expecially in those patients
with limited disease and favorable performance status.
