BACKGROUND: Elderly patients are excluded from chemotherapy trials, even though they represent 25% of those with small cell lung cancer. An effective chemotherapy regimen with limited toxicity should be developed with the aim not only of increasing the survival of these patients, but also of improving their quality of life and their independence. PATIENTS AND METHODS: Twenty-four patients with a median age of 72 years and small-cell lung cancer (SCLC) were included in the trial. Chemotherapy consisted of a weekly intravenous regimen of Carboplatin 80 mg/m2 and Teniposide 80 mg/m2 administered on an outpatient basis. RESULTS: Eight patients had limited and 16 extensive disease. After a median of 12 chemotherapy courses (2-31) the overall response rate was 66.7% (95% Cl: 44.7-84.4), with 5 patients in complete and 11 in partial remission. The median overall survival was 33 weeks, with 4 patients alive at more than one year. Improvement of symptoms occurred in 86% of patients. Toxicity, mainly hematological, was moderate. CONCLUSIONS: Weekly Carboplatin and VM-26 is an effective and non-toxic regimen for elderly patients, leading to results similar to those obtained with a more intensive regimen in a younger age group.