Ten patients with metastatic small cell lung cancer (SCLC) in the brain, shown by CT scan at time of diagnosis, were treated with systemic combination chemotherapy. Repeated CT scans were performed every 4 weeks. Seven patients were evaluable, since three patients died during the first 2-3 weeks. Significant responses on CT scans as well as neurologic improvement were demonstrated in all evaluable patients. Four of seven patients obtained a complete response in the brain, while three had partial remissions. The impact of this observation on the overall treatment strategies in SCLC has further to be defined.