HemeOnc

Small Cell Lung Cancer

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Small Cell Lung Cancer

  • Background
  1. Accounts for 15-20% of Lung Cancers
  2. Central, large cancers with Lymphadenopathy
  3. Associated with paraneoplastic syndromes
  • Staging
  1. TNM Staging System
    1. Recommended by American College of Chest Physicians (ACCP)
    2. Staging Calculator
      1. http://staginglungcancer.org/calculator
  2. Veterans Administration Lung Study Group Classification System
    1. Limited: Lesion confined to ipsilateral chest
    2. Extensive: Metastases beyond ipsilateral chest
  • Management
  1. Limited stage
    1. Intent to cure management is associated with a 25% five year survival
    2. Surgical resection may be indicated
    3. Chemotherapy (one platinum-based agent and at least one other agent)
    4. Radiation Therapy
  2. Extensive stage
    1. Five year survival approaches 0%
    2. Chemotherapy and radiation as above
  3. Other measures
    1. Cranial Irradiation
      1. Prophylactic cranial irradiation improves survival
      2. Auperin (1999) N Engl J Med 341:476-84 [PubMed]