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Limited stage small of small cell lung cancer (sclc)
There are two stages of small cell lung cancer: "extensive stage" (cancer that has spread outside the chest) and "limited stage" (generally cancer confined to the chest).
The main distinction of limited stage of cancer is that it can be found only in one lung and in nearby lymph nodes.
There are several ways of treatment:
- Surgery and the following chemotherapy with or without prophylactic cranial irradiation.
- Radiation chemotherapy and therapy to the chest. It can be accompanied by prophylactic cranial irradiation - radiation therapy to the brain to prevent spread of the cancer.
- Chemotherapy with or without prophylactic cranial irradiation.
According to statistics approximately 30% of patients with small cell carcinoma at the time of diagnosis already has developed tumor confined to the hemithorax of origin, the supraclavicular lymph nodes or the mediastinum. Most 2-year disease-free survivors come from the group of patients with limited stage of small cell lung cancer. Median survival of 16 to 24 months is quite common in limited-stage disease. Certainly all possible forms of treatment can reasonably be expected. For a small group of patients with limited-stage disease surgery is even more efficient with or without adjuvant chemotherapy. The prognosis for this group of patients is even better.
In cases of limited-stage small cell lung cancer, single-agent treatment is less effective than combination chemotherapy. Moderately intensive doses of drugs are superior to doses that produce only minimal hematologic toxic effects. For patients with limited-stage small cell lung cancer chemotherapy is the cornerstone of treatment because of the frequent presence of occult metastatic disease. 2 or more drugs are needed to be combined for maximal effect.
Standard treatment options:
- Surgical resection that is accompanied by chemotherapy or chemotherapy plus chest radiation therapy (with or without PCI in patients with complete responses) for patients with stage I disease.
- Combination chest irradiation (with or without PCI given to patients with complete responses) with chemotherapy.
- For patients with impaired pulmonary function or poor performance status - combination chemotherapy (with or without PCI in patients with complete responses).
Treatment options under clinical evaluation:
Treatment options can be following: new drug regimens, surgical resection of the primary tumor, variation of drug doses in current regimens, timing of thoracic radiation and new radiation therapy schedules and techniques (e.g., 3-dimensional treatment planning).
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