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Risk/benefit analysis of drugs requires not only the reporting and documentation of adverse drug reactions in clinical trials but also a spontaneous reporting system for the detection of rare adverse reactions to drugs. A central aspect of any spontaneous reporting system is assessment of causality on the basis of detailed case histories. However, besides the qualitative description of adverse drug reactions, information about the incidence of such reactions has to be obtained as well so that their frequency, and thus the risk involved, can be established.

The authors studied the effect of a chemo-/radiotherapy or radio-/chemotherapy on 52 cases of microcellular bronchial carcinoma, classification "limited disease". The survival curves were slightly better for the patients submitted to primary chemotherapy, but the difference was not statistically significant, and the curves coincided again after 18 months. 60 to 80% of the patients had no complaints or only unimportant complaints during more than half of their survival time. In 23 patients with "extensive disease" who received only a symptomatic therapy or a combined palliative chemotherapy, chemotherapy had a slightly better effect, but this was not statistically significant.

The success of chemotherapy of inoperable endothoracic cancer largely depends on interdisciplinary cooperation. 30 years of research have succeeded in developing some promising combinations of cytostatic agents. Administered sequentially they are better tolerated and this has made outpatient treatment possible. 87 persons had polycytostatic therapy according to the Karrer/Sighart formula. It was followed by a difinite improvement in the general condition of the patients, but without any substantial lengthening of the average survival time. The ACO scheme (Seeber/Schmidt) has been used since April 1977 in 42 persons. Preliminary results indicate a definite prologation of survival time, especially in cases of small-cell bronchogenic carcinoma.