Role ofhistamine released in hypertonic saline induced bronchoconstriction
The lengthy and balanced editorial on treatment duration in small cell lung cancer (January 1990;45:1-2) makes no mention of the first large scale randomised trial specifically addressing this question to be published world wide. In 1986 we reported a randomised trial with over 300 patients, which resulted from collaboration amongst chest physicians, radiotherapists, and medical oncologists in Nottingham and elsewhere in the Midlands.' Unlike most subsequent trials we chose not to randomise patients who had clearly demonstrable signs of residual disease after an initial period of induction chemotherapy (that is, partial remissions or failures) as we felt intuitively that these patients (whose tumours were thus not very sensitive to chemotherapy) were very unlikely to benefit from more of the same. The results of the later trials have confirmed that our suspicions were correct. In the Midlands trial limited and extensive stage patients who had responded very well to induction treatment were randomised separately. There were inadequate numbers of limited stage cases for worthwhile conclusions. In extensive disease, however, there