Fifty-eight patients with small cell carcinoma of the lung were treated with a combined modality regimen: chemotherapy with adriamycin, cyclophosphamide and vincristine; BCG immunotherapy; radiotherapy to the lung primary and prophylactic cranial irradiation. Nineteen patients had limited disease, and 39 had extensive disease. There were 27 (48%) partial remissions and 23 (41%) complete remissions, and median survival was 51 wk. Initial performance status and extent of disease had a definite effect on survival. Only 1 patient developed CNS metastases on prophylactic cranial irradiation. Five of 19 patients (26%) with limited disease remain alive and in complete remission at 26-45+ mo. Median survival in small cell lung cancer can be prolonged. Limited extent small cell lung cancer may be potentially curable.