CONTENT:

8.3 Small Cell Lung Cancer Treatment
8.3.1 Small Cell Lung Cancer Treatment Overview
8.3.2 Surgery
8.3.3 Chemotherapy
8.3.3 Radiation Therapy

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I’ve just tried to look up impotence on the internet, but nothing came up.

8.3  Small Cell Lung Cancer Treatment: (SCLC)

 
For patients with Small Cell Lung Cancer (SCLC), studies have shown that the outcome of treatment is, generally, not affected by the stage of the tumor. The two stages that used are, ‘limited-stage’ and ‘extensive-stage’ SCLC.

8.3.1 Overview of Small Cell Lung Cancer Treatment

 
The reason for the importance placed on determining the neuroendocrine origin of a lung cancer, as is the case for small cell lung cancer, is because this type of lung cancer is very responsive to chemotherapy and radiation treatment.

Small cell lung cancer is a very rapidly-growing cancer that begins to metastasize very early on in its growth. Because of this behavior, small cell lung cancer usually presents with metastatic disease; this is why treatment strategies are those of systemic (whole-body) therapy.

Studies have shown that local tumor spread occurs in up to 80 % of patients with small cell lung cancer when treated with chemotherapy alone. In addition, the combined use of thoracic radiation therapy, significantly reduces the high local recurrence rate.

Patients with limited-stage small cell lung cancer will have chemotherapy, thoracic radiation therapy and possibly prophylactic radiation treatment of the brain.

Table 8.3  Treatment of Small Cell Lung Cancer (SCLC)

8.3.2 Surgery

 
For patients with limited-stage small cell lung cancer who have no distant metastases, no evidence of disease in the mediastinum and no clinical contraindications to surgery, surgical resection is indicated.   Adjuvant chemotherapy, with four cycles of cisplatin-based treatment, follows the surgery.

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8.3.3 Chemotherapy

 
Chemotherapy is a treatment option for both limited-stage and extensive-stage small cell lung cancer.

Firstly, for limited-stage disease, a single chemotherapeutic drug is used in combination with radiation. More commonly, a platinum-based drug (carboplatin or cisplatin) in combination with etoposide.  Alternative treatment includes combination chemotherapy with four cycles of a platinum-based regimen in conjunction with thoracic radiation therapy.

For patients who have symptoms of superior vena cava (SVC) obstruction, chemotherapy is the initial treatment of choice as the response to chemotherapy is usually rapid.

In extensive-stage disease, a combination of two chemotherapeutic drugs may be necessary, the choice of which may vary.

Radiotherapy, that word is scary. It’s thinking you may lose your hair and be very sick.

You don’t lose your hair from radiation, it doesn’t give you nausea, and it is pain free. It’s a fantastic treatment, except for being a bit boring.

Just invest in a good book. ‘Every which way but Moose’ is not bad.

8.3.4 Radiation Therapy

 
Radiation treatment is used in almost all cases of  limited-stage small cell lung cancer.  A single external radiation port may treat limited-stage small cell lung cancer.

Limited thoracic radiation therapy fields will include the residual post-chemotherapy tumor and all involved lymph node regions. In some cases, oncologists will use thoracic radiation therapy with the first or second cycle of chemotherapy, rather than with later cycles of chemotherapy.

In some cases, together with the first or second cycle of chemotherapy, the treating medics also give thoracic radiation therapy.

If patients with extensive-stage small cell lung cancer do not respond to chemotherapy, radiation therapy may be necessary.  For extensive tumors, radiation to larger areas of the body may be necessary.  Sometimes, oncologists will use thoracic radiation therapy and chemotherapy together .  In other cases, radiation therapy may be necessary after the completion of chemotherapy.

Positron emission tomography (PET) can image the thorax and also has a role in radiation treatment planning.

Patients who have a good, partial response to their initial chemotherapy may have prophylactic cranial irradiation (PCI).  Also, if there is metastasis from small cell lung cancer to the brain, PCI is sometimes the treatment of choice .

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References

Warde P, Payne D. (1992) Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. JCO Apr 1, 2014:973-982 (Retrieved 4^thMay 2015): http://jco.ascopubs.org/content/10/6/890.short

Cooper S, Spiro SG. (2006). Small cell lung cancer: treatment review. (Retrieved 4^th May 2015): Respirology. 2006 May;11(3):241-8. http://www.ncbi.nlm.nih.gov/pubmed/16635081

More references for this section are on this page .

Patient Information

American Cancer Society Chemotherapy for small cell lung cancer (Retrieved 30^th April 2015): http://www.cancer.org/cancer/lungcancer-smallcell/detailedguide/small-cell-lung-cancer-treating-chemotherapy

Medline Plus Lung cancer – small cell (Retrieved 3^rd May 2015): http://www.nlm.nih.gov/medlineplus/ency/article/000122.htm

More patient information for this section is on this page .

Forward to 8C Recurrence and Future Trends . Back to 8A Treatment of Non-Small Cell Lung Cancer .