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Patients with Small-Cell Lung Cancer Treated with Combination Chemotherapy with or without Irradiation: Data on Potential Cures, Chronic Toxicities, and Late Relapses After a Five- to Eleven-Year Follow-up

BRUCE E. JOHNSON, M.D.; DANIEL C. IHDE, M.D.; PAUL A. BUNN, M.D.; BRUCE BECKER, Ph.D.; THOMAS WALSH, M.D.; ZELIG R. WEINSTEIN, M.D.; MARY J. MATTHEWS, M.D.; JACQUELINE WHANG-PENG, M.D.; ROBERT W. MAKUCH, Ph.D.; ANITA JOHNSTON-EARLY, R.N.; ALLEN S. LICHTER, M.D.; DESMOND N. CARNEY, M.D.; MARTIN H. COHEN, M.D.; ELI GLATSTEIN, M.D.; and JOHN D. MINNA, M.D.
[+] Article and Author Information

▸From the National Cancer Institute-Navy Medical Oncology Branch, the Radiation Oncology Branch, the Medicine Branch, and the Biostatistics and Data Management Section, National Cancer Institute and Naval Hospital; and the Internal Medicine Department, Psychiatry Department, and Radiology Department, Naval Hospital, Naval Medical Command, National Capital Region, Bethesda, Maryland; and the Medical Service, Veterans Administration Center, Washington, D.C.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy or the Department of Defense.

▸Requests for reprints should be addressed to Daniel C. Ihde, M.D.; NCI-Navy Medical Oncology Branch, Building 8, Room 5108, Naval Hospital; Bethesda, MD 20814.


Bethesda, Maryland; and Washington, D.C.


Ann Intern Med. 1985;103(3):430-438. doi:10.7326/0003-4819-103-3-430
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We assessed the outcome in 252 patients with small-cell lung cancer 5 to 11 years after treatment with combination chemotherapy, with or without chest and cranial irradiation, in National Cancer Institute therapeutic trials from 1973 through 1978. Twenty-eight patients (11%) survived free of cancer for 30 months or more. Fourteen patients remain alive without evidence of cancer beyond 5 years (range, 6.4 to 11.3 years), and 7 patients have returned to a lifestyle similar to that before diagnosis. The other 14 patients who were cancer-free at 30 months have developed cancer or died; 6 patients had a relapse, 4 developed or died from non-small-cell lung cancer, and 4 died of unrelated causes. A few patients with small-cell lung cancer (5.6%) may be cured. Thirty-month, cancer-free survival is insufficient to show a cure. Although late toxicities are troublesome, they do not outweigh the benefits of prolonged survival and potential for cure with modern aggressive therapy in small-cell lung cancer.

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