Non-cross resistant regimen consisting of VIP rapidly alternating with CAV has been studied in 45 patients with small cell lung cancer. VP-16 60 mg/m i.v. on days 1-5, ifosfamide 1000 mg/m i.v. on days 1-5, and cis-platinum 60 mg/m i.v. on day 1 was alternated at interval of 3 weeks with cyclophosphamide 1000 mg/m i.v. on day 1, adriamycin 45 mg/m i.v. on day 1 and vincristine 1. 4 mg/m i.v. on day 1. For 27 patients with limited disease, indution chemotherapy with one cycle of VIP and CAV was followed by radiotherapy to primary tumor, both supraclavicular lymph nodes and prophylactic whole brain irradiation. Three to four weeks after the completion of radiotherapy, 12 cycles of VIP and CAV were maintained. Eighteen patients with extensive disease were treated with chemotherapy alone. The results obtained were as follows; I) A 92.6% overall response rate and 44.S% complete remission rate in limited disease and 61. 1% overall response rate and 11.1% complete remission rate in extensive disease were achieved. Overall resonse rate in both stage disease was 80.0% and the rate of complete and partial remission was 33.3% and 46.6% respectively. 2) The overall median duration of remission was 49.2 weeks. The median duration of remission was not reached in limited disease group (range, 4-92+weeks) and 34.5 weeks in extensive disease group. The duration of remission for the complete responders was much longer than that for the partial responders (P<0.01).
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