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Extensive stage of small cell lung cancer (sclc)
There are two stages of small cell cancer: "extensive stage" (cancer that has spread outside the chest) and "limited stage" (generally cancer confined to the chest).
During the extensive stage cancer starts to develop in other tissues in the chest or to other parts of the body. So an extensive-stage disease means that patients have tumors that have spread beyond the supraclavicular areas. The prognosis of such patients are worse than those with limited-stage disease. The average survival is reported to be from 6 to 12 months even using the currently available therapy. Unfortunately long-term disease-free survival is reported rarely.
- Radiation therapy to body parts where there are evidences of developing cancer. For example: brain, bone, or spine.
- Chemotherapy that can be accompanied by prophylactic cranial irradiation - radiation therapy to the brain to prevent spread of the cancer.
If to compare patients that have extensive-stage small cell carcinoma with limited-stage disease they have greatly impaired performance status at the time of diagnosis. Such patients tolerate combined modality therapy or aggressive chemotherapy poorly so they have a very poor prognosis. According to some studies it was shown that patients with a poor prognosis who are treated with the single-agent or low-dose regimens live shorter than those who are treated with conventional regimens.
Treatment under clinical evaluation:
Evaluation of new drug regimens, dose intensity, alternative drug schedules, and high-dose chemotherapy - that are all the areas of active clinical evaluation in extensive-stage small cell lung cancer. According to meta-analysis of long-term outcomes we can say that there is no consistent evidence for improved survival or response rates for more intense chemotherapy regimens.
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