The standard treatment of small-cell lung cancer consists of four to six cycles of polychemotherapy and usually includes local thoracic radiation (stages I-III); in principle, surgery is also possible (early stage). When complete remission is achieved, prophylactic whole brain irradiation is recommended. Nevertheless, the standard treatment regimen needs improvement as evidenced by recent statistical data (Symposium on the Interdisciplinary Treatment of Lung Cancer, Münster 2001: median survival 12-16 months, local control 40-60%, 2-year survival 40%, and 5-year survival 20%). Aspects of an optimal integration of radio- and chemotherapy like timing, fractionation and efficacy are represented and discussed in this review. From the current point of view, it can be asserted that thoracic radiotherapy and prophylactic whole brain irradiation are essential to ensure a high rate of long-term survival.