11-week course of sequential methotrexate, thoracic irradiation, and moderate-dose cyclophosphamide for "limited"-stage small-cell bronchogenic carcinoma. A study from the Manchester Lung Tumour Group.

55 patients with inoperable but "limited"-stage small-cell carcinoma were treated sequentially with methotrexate, radiotherapy, and high doses of cyclophosphamide. The treatment was completed over 11 weeks and no maintenance chemotherapy was given. Follow-up lasted 9-29 months. Toxicity was acceptable, despite doses of cyclophosphamide of 1.5-3.5 g/m2. The complete response rate was 53%. Median survival for the total patient group was 12 months, range 2-29+. Patients who attained a complete response had a 17 month median survival; 17 patients remained in complete remission, 9 of whom first underwent treatment 14-29 months previously. Karnofsky performance scores improved after treatment and most patients were able to resume normal activity. The results are similar to those obtained with prolonged combination chemotherapy.