Limited stage small cell lung cancer: Initial management
- Elizabeth H Baldini, MD, MPH
Elizabeth H Baldini, MD, MPH
- Associate Professor of Radiation Oncology
- Harvard Medical School
- Gregory P Kalemkerian, MD
Gregory P Kalemkerian, MD
- Professor of Medicine
- Co-Director, Thoracic Oncology
- University of Michigan Medical Center
- Section Editors
- Rogerio C Lilenbaum, MD, FACP
Rogerio C Lilenbaum, MD, FACP
- Section Editor — Lung Cancer
- Yale Cancer Center
- James R Jett, MD
James R Jett, MD
- Section Editor — Lung Cancer
- Professor of Medicine Emeritus
- National Jewish Health
- Steven E Schild, MD
Steven E Schild, MD
- Section Editor — Radiation Therapy
- Professor of Radiation Oncology
- Mayo Clinic College of Medicine
Small cell lung cancer (SCLC) is a poorly differentiated neuroendocrine tumor that represents about 15 percent of all lung cancers. Nearly all patients with SCLC are current or former smokers. (See "Cigarette smoking and other possible risk factors for lung cancer".)
SCLC is distinguished from non-small cell lung cancer (NSCLC) by its rapid doubling time and high growth fraction, and the early development of metastases. SCLC usually presents with disseminated disease, and treatment strategies have focused on systemic therapy. For patients with limited stage disease, treatment also includes radiation therapy directed toward thoracic disease, as well as prophylactic treatment of the brain.
The initial management of patients with limited stage SCLC is reviewed here. Related topics include:
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- STAGING AND GENERAL APPROACH TO TREATMENT
- Limited stage disease
- Extensive-stage disease
- BENEFIT OF TREATMENT
- Etoposide plus cisplatin
- - Carboplatin versus cisplatin
- Other regimens
- - Irinotecan-containing regimens
- - Paclitaxel-containing regimens
- - Novel agents
- THORACIC RADIATION THERAPY
- Benefit of RT
- Treatment volume
- Fractionation schedule
- - Accelerated hyperfractionation
- - Split course treatment
- PROPHYLACTIC CRANIAL IRRADIATION
- INTEGRATION WITH CHEMOTHERAPY
- Sequential, concurrent, and alternating approaches
- Early versus late thoracic RT
- - Rationale
- - Clinical trials
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS