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Purposes: Although the standard management oflimited stage small cell lung cancer is concurrent platinum-based chemotherapy with thoracic radiotherapy(TRT), the optimal timing of the TRT remains controversial. We investigated the feasibility of concurrentchemoradiation for the patients with limited stage smallcell lung cancer after 2 cycles of combination chemotherapywith Etoposide/Cisplatin (EP). Materials and Methods: EP consisted of Etoposide 100mg/m2 on day 1 to 3 and Cisplatin 70 mg/m2 on day 1. Six cycles were given to the responders every 4 weeks. Total 55 Gy (1.8 Gy once-daily or 1.2 Gy twice-daily, 5days per week) of TRT were given to the patients whoshowed at least a partial response after 2 cycles of EP. The other patients were treated by the physician'sdecision. The patients with complete remission wererecommended to receive prophylactic cranial irradiation. Results: Fifty patients were enrolled. Thirty-five (70%)of them showed responses (2 complete remissions and33 partial remissions) after 2 cycles of EP. Thirty-threeof the responders were given TRT starting with the 3rdcycle of EP. The nonresponders were treated with salvagechemotherapy and TRT. After completion of treatment for50 patients, the overall response rate was 86% (29complete remissions, 14 partial remissions). One patient(2%) showed stable disease, and 6 (12%) showed aprogressive disease. The median progression free survivalwas 326 days and the median survival time was 410days. One-, 2-, 3-, 4- and 5-year survival rates were 62%,24%, 14%, 9% and 6%, respectively. As hematologic toxicitiesduring chemoradiation, 35.1% with grade III/IV neutropeniaand 18.9% with grade III/IV thrombocytopeniawere noted. Grade II/III radiation pneumonitis and radiationesophagitis were noted in 5/1 and 13/1 patients (15.2%/3.0% and 39.4%/3.0%), respectively. One patient died ofsepticemia during chemoradiation. Conclusion: The concurrent EP and TRT after 2 cyclesof EP was feasible in limited stage small cell lung cancer. Further study is required for the indentification of optimumtiming of TRT during combination chemotherapy. (Cancer Research and Treatment 2002;34:409-415)