Prolonged survival of patients with extensive oat cell carcinoma treated with radiotherapy and cyclophosphamide (NSC 26271), vincristine (NSC 67574), and methotrexate (NSC 740)

During the past 3 yr, combination therapy for oat cell carcinoma of the lung has improved the dismal natural history of this disease, for which the median survival had been 3 mth. Recently, Eagan et al. reported a median survival of 9.5 mth in patients with oat cell carcinoma treated with radiotherapy and combination chemotherapy. The authors used a protocol similar to that of Eagan. Chemotherapy consisted of cyclophosphamide, vincristine, and methotrexate (CVM). They have confirmed the results reported by others in a group of 18 patients, 16 of whom had extensive bone or liver disease. The median survival of all patients treated was 9 mth. Responders (CR and PR) had a median survival of 11 mth which was attained with negligible toxicity. There was a very significant difference in survival between responders (CR and PR) and nonresponders: 11 mth versus 1.8 mth respectively (P=0.01). It is possible to predict which patients will respond, since objective response is usually seen within the first 2 cycles of chemotherapy.