Infusion cisplatin chemotherapy and hyperfractionated thoracic radiotherapy for small-cell lung cancer

Sixty patients, 29 with limited disease and 31 with extensive disease, received an infusion cisplatin-based chemotherapy regimen and, where applicable, subsequent hyperfractionated thoracic radiation therapy (HTRT). Of the patients with limited disease, the response rate was 100% (76% complete response); median survival 26.5 months; 1- and 2-year survival 90 and 55%, respectively. Of those with extensive disease, 96% responded (36% complete response) with median survival 12.0 months and 1- and 2-year survival 48 and 29%, respectively. Thirty-five percent of extensive disease patients were downstaged to a 'limited' status, with a median survival of 20.3 months. Grade IV leukopenia and thrombocytopenia were seen in 25 and 7% of patients, respectively, with one patient dying of radiation pneumonitis. Within the constraints of the study, infusion cisplatin-based chemotherapy and HTRT appear to be a safe and effective program for the treatment of small-cell lung cancer.