Twenty-eight patients with small cell carcinoma of the lung were studied for their response to combination chemotherapy and radiation therapy, frequency of bone marrow metastases, and clinically evident hormonal syndromes. Seventeen of 19 evaluable patients who received cyclic monthly courses of highdose cyclophosphamide and vincristine had objective responses. Five of seven patients treated with procarbazine from day 14-28 of the cycle had progressive disease. Methotrexate (0.75-1.0 mg/kg) administered on day 21 only or days 21 and 28 after cyclophosphamide and vincristine proved to be superior as a single agent with 6 of 14 patients responding and 8 of 14 showing no progression of disease. Radiation therapy to the primary tumor was effective in all dose schedules, but appeared superior when 3200 rads given in 10 doses over 12 days (1401 rets) was administered at the completion of the second course of chemotherapy. Ten of 24 patients had bone marrow metastases at the time of the initial diagnosis and bone marrow aspiration should be used as a staging procedure. Six of 28 patients had clinical or laboratory evidence of hormonal or neurologic abnormalities.
MALL CELL CARCINOMAS OF THE LUN@ S comprise 6-150/, of all primary bronchogenic tumors.5~~.3? They are highly malignant tumors with a median survival of about 2 months when diagnosed with extrathoracic disease9.18 and with a 5-year survival of less than 1yo.22 On roentgenogram of the chest, a hilar or perihilar mass or a hilar prominence is the most common finding, occuring in about 750/, of patients examined.? There is about a 45% incidence of bone marrow metastases at the time of diagnosis.19~20 Because of these characteristics, small cell carcinoma of the lung is usually inoperable.10.3?
Response to chemotherapy has been seen