Randomized Study of Cisplatin-Etoposide Versus an Etoposide Regimen Without Cisplatin in Extensive Small-Cell Lung Cancer

Inclusion Criteria: * Histological or cytological diagnosis of small-cell lung cancer * Extensive disease (i.e. a disease with distant metastases or that cannot be included in a single irradiation field incorporating primary tumour, mediastinum and supraclavicular lymph node(s)) * Availability for participating in the detailed follow-up of the protocol * Presence of an evaluable or measurable lesion * Informed consent Exclusion Criteria: * Prior treatment with chemotherapy, radiotherapy or surgery * Performance status \< 60 on the Karnofsky scale * A history of prior malignant tumor, except non-melanoma skin cancer or in situ carcinoma of the cervix or a cured cancer (defined as a disease-free interval \> 5 years) * White blood cells \< 4000/mm3 * Platelets \< 100000/mm3 * Serum bilirubin \> 1.5 mg/100 ml * Serum creatinine \> 1.3 mg/100 ml and creatinine clearance \<60 ml/min * Recent myocardial infarction (less than 3 months prior to date of diagnosis) * Congestive cardiac failure or cardiac arrhythmia uncontrolled by medical treatment * Uncontrolled infectious disease * Serious medical or psychological factors which may prevent adherence to the treatment schedule