From 1974 to 1984, we have treated 70 patients with SCLC using radiotherapy (RT) alone or in combination with chemotherapy (CT). It was demonstrated that a heavy CT regimen causing a severe toxicity did not always cause good results. On the other hand, there was a long-term survivor in those patients who were treated with RT alone. Considering from our results as well as from reviews of literatures, it is evident that RT can reduce a significant number of local relapses but has little effect on systemic disease. Therefore, RT added to CT seems to improve a long-term survival specifically in those patients in whom CR is induced from CT. The characteristics of the long-term survivors treated with combined treatment are: limited disease, thoracic RT, good PS, only single site of metastases. In conclusion, there is no doubt that CT plays an important role in the management of SCLC. However, its efficacy is still far from desired, and a new type of CT is warranted.