Radiotherapy alone or with chemotherapy in the treatment of small-cell carcinoma of the lung

Findings at one year are given of a study comparing radiotherapy (Rt) with radiotherapy followed by 3-drug chemotherapy (RtC3) in the treatment of small-cell carcinoma of the lung of limited extent. Over the 12-month period there was a significantly increased survival for the RtC3 patients. The median survival for the Rt series was 25 weeks and for the RtC3 series 43 weeks. There was evidence of recurrence of the primary cancer in 32% of the Rt and 26% of the RtC3 patients who died. Distant metastases appeared earlier and were more frequent in the Rt series. At 12 months only 8% of the Rt but 26% of the RtC3 patients were alive and free of metastases. Adverse reactions occurred much more frequently in the RtC3 series; the most common being nausea and vomiting and the most serious being marrow depression. No important differences were found in general condition, physical activity or respiratory function. It is concluded that radiotherapy plus chemotherapy was superior to radiotherapy alone, although chemotherapy did not protect patients from recurrence of primary growth. (author)