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