II. Background
- Accounts for 15-20% of Lung Cancers
- Central, large cancers with Lymphadenopathy
- Associated with paraneoplastic syndromes
III. Staging
IV. Management
- Available Therapy
- Chemotherapy
- Cisplatin (or Carboplatin if significant Chronic Kidney Disease)
- Etoposide (Etopophos)
- Radiation Therapy
- Consolidative Thoracic Radiation
- Considered in patients with residual localized Lung Lesions responding to Chemotherapy
- Cranial Irradiation
- Prophylactic for brain metastases in limited stage SCLC (reduces mortality)
- Localized palliative radiation
- Non-pulmonary metastases
- Whole brain Radiotherapy
- Brain metastases
- Consolidative Thoracic Radiation
- Chemotherapy
- Limited stage
- Intent to cure management is associated with a 25% five year survival
- Chemotherapy with concurrent Radiotherapy (see above)
- Surgical resection of localized lesions may be indicated
- Extensive stage
- Five year survival approaches 0% (two year survival <10%)
- Chemotherapy with Immunotherapy for 4 to 6 cycles
- Maintenance Immunotherapy after initial cycles
- Radiation Therapy as above
- Other measures
- Cranial Irradiation
- Prophylactic cranial irradiation improves survival
- Auperin (1999) N Engl J Med 341:476-84 [PubMed]
- Cranial Irradiation