Treatment of small cell carcinoma with weekly combination chemotherapy. A pilot study.

We conducted a prospective non-randomized pilot study to evaluate the response rate and toxicity of weekly combination chemotherapy in pulmonary and extrapulmonary small cell carcinoma. A consecutive collection of 13 patients seen at the University of Virginia Medical Center was entered into the study after written informed consent. Ten of these patients had small cell carcinoma of the lung (4 with limited disease and 6 with extensive disease) and 3 patients had extrapulmonary small cell carcinoma (esophagus, cervix, and larynx). The treatment regimen consisted of weekly chemotherapy for 16 weeks using six cytotoxic agents (cisplatin, vincristine, methotrexate, adriamycin, cyclophosphamide, and VP-16) in different combinations followed by radiotherapy to the primary site. To date, ten patients have completed chemotherapy and radiotherapy with 9 (90%) achieving a complete response. The overall objective response rate was 100%. Of the remaining 3 patients who are currently receiving treatment, one achieved a complete response and two are showing significant responses. This ongoing trial shows that a weekly combination chemotherapy regimen is effective in producing high response rates in small cell carcinoma.