1977 Volume 68 Issue 3 Pages 321-331
In order to clarify the relationship between histological subtypes or small cell carcinoma and the degree of their response to chemotherapy, 58 cases of small cell carcinoma of the lung were studied. Cyclophosphamide, vincristine, and 5-fluorouracil were administered intravenously. Fifty percent survival of small cell carcinoma patients was the longest in the stage I group and shortest in the stage III group, regardless of the secondary treatment. Fifty percent survival was the longest in the group responding markedly to the initial chemotherapy and shortest in the non-responding group, regardless of the clinical stage. The chemotherapy was found effective on the lymphocyte-like subtype according to the WHO histological classification, the fusiform cell type and the polygonal cell type, in that decreasing order. Different ultrastructural findings were observed in cases in the responding group and in the non-responding group. Noteworthy findings were (a) a marked irregularity in the nuclear shape, (b) irregular distribution of abundant condensed chromatins, (c) many perichromatin granules, and (d) abundant nucleolus-associated chromatins in the non-responding group. Although almost all small cell carcinoma contained neurosecretory granules, granules were few in the non-responding group.
