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Small Cell Lung Cancer
Aka: Small Cell Lung Cancer
- See Also
- Lung Cancer
- Non-Small Cell Lung Cancer
- Background
- Accounts for 15-20% of Lung Cancers
- Central, large cancers with Lymphadenopathy
- Associated with paraneoplastic syndromes
- Staging
- TNM Staging System
- Recommended by American College of Chest Physicians (ACCP)
- Staging Calculator
- http://staginglungcancer.org/calculator
- Veterans Administration Lung Study Group Classification System
- Limited: Lesion confined to ipsilateral chest
- Extensive: Metastases beyond ipsilateral chest
- 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
- 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]
- References
- Kim (2022) Am Fam Physician 105(5): 487-94 [PubMed]
- Latimer (2015) Am Fam Physician 91(4): 250-6 [PubMed]