Gemcitabine has modest activity in patients with resistant SCLC. There is some non-cross resistance to most agents against SCLC.

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Background: The alveolar volume (V_A), determined by single-breath helium dilution, is a measure for the total lung capacity (TLC) that is very sensitive to ventilatory disturbances. In chronic obstructive pulmonary disease (COPD), the emphysematous lung parts are less accessible to test gas; therefore, the V_A is smaller than TLC measured by multiple-breath helium dilution (TLC_He). Objectives: The aim of this study was to investigate whether the V_A represents the nonemphysematous lung parts. Methods: We measured V_A as part of the diffusing capacity for carbon monoxide (DL_CO), TLC_He and spirometry in 50 patients with COPD. High-resolution computed tomography (HRCT) scans of all subjects were analyzed with the density mask method, where parts with an attenuation of less than –950 Hounsfield units were considered as emphysematous. Results: A strong correlation was observed between the V_A (mean 5.2 liters) and nonemphysematous HRCT lung volume (mean 5.2 liters, r² = 0.9) and between the TLC_He (mean 6.6 liters) and total HRCT lung volume (mean 6.4 liters, r² = 0.9). Bland-Altman plots showed considerable disagreement between the V_A and the nonemphysematous HRCT lung volume. A weak correlation between the forced expiratory volume in 1 s (mean 46% predicted) and DL_CO (mean 46% predicted) versus the HRCT emphysema ratio (nonemphysematous/total HRCT lung volume) was observed (r² = 0.3 and 0.3, respectively). Conclusion: We concluded that the V_A correlates with the nonemphysematous HRCT lung volume, although the two measurements are not equivalent, possibly due to technical factors.