[Drug therapy in XXXX ].

@entity1 @entity66 @entity5 @entity1149 @entity262 @entity189 @entity900 @entity153 @entity151
In the treatment of @entity153 approaches vary depending upon whether the @entity189 in question is defined as a small cell or a @entity1149 . @entity151 in the majority of cases must be seen as a @entity262 even with an early diagnosis. Because of this, chemotherapy is the dominant form of treatment. For @entity1 with limited disease radiotherapy and surgery are additionally recommended as potentially curative measures, and for those with @entity66 , surgery and radiotherapy may serve as palliative treatment. Chemotherapy generally consists of a combination of two or more cytostatic drugs. As a rule 4 to 6 treatment cycles are administered. Maintenance therapy appears to be of little value. In case of @entity5 relapse, new cytostatic combinations can be attempted or the cytostatic regimen which was originally successful can be reintroduced. Whether or not a @entity5 responds to a particular chemotherapy is apparent after the first cycle of treatment. When the @entity5 shows no @entity151 , the treatment regimen can immediately be changed. The question of possible intensification of induction chemotherapy has yet to be clarified by clinical trials. The data gathered thus far, however, suggest that there is no measurable improvement in survival rates when chemotherapy is intensified beyond standard practice. In the case of @entity1149 , the disease is predominantly characterized by locally limited @entity5 growth, so that radiotherapy and surgery are initially the preferred forms of treatment. Systemic therapy in @entity1149 has thus been mainly reserved for the stage of @entity5 dissemination (stage IV). For these @entity1 chemotherapy has proved generally to have a purely palliative effect which is of limited duration. Recent clinical trials indicate, however, that better results can be obtained when chemotherapy is applied in stage III. These encouraging results stem from a number of clinical studies, in which polychemotherapy containing @entity900 (with or without radiotherapy) was applied preoperatively to initially inoperable @entity5 @entity1 . It must be noted, however, that up until now these positive results have been achieved mainly in uncontrolled clinical investigations which must be confirmed by larger controlled trials.
