Aggressive Palliation in Extensive Stage Small Cell Lung Cancer, Practice Guidelines versus Clinical Practice: A Case Report and Review of the Literature

Lung Cancer International
Edward F MilesJohn W Nelson

Abstract

Small cell lung cancer (SCLC) constitutes approximately 16% of all primary lung cancers, with more than 35,000 new cases per year. Two-thirds of patients present with extensive stage disease (ES-SCLC) due to a tendency to metastasize early. Outcomes remain poor, with a median survival of approximately 10 months and a two-year overall survival of <10%. Current recommendations call for combination chemotherapy alone in patients without localized symptoms. Thoracic radiation therapy following a good clinical response is controversial. We report on a patient with ES-SCLC that had an excellent response to chemotherapy and underwent whole brain radiotherapy for a known brain metastasis and consolidative radiotherapy to the thorax. His latest follow-up demonstrates only a stable residual pulmonary nodule and no evidence of active metastatic disease. ES-SCLC is a relatively common presentation with a variable burden of metastatic disease. In the absence of randomized trials demonstrating the efficacy of thoracic radiation therapy, the community radiation oncologist is placed in a difficult position when addressing these patients, particularly those with otherwise good performance status and a good response to initial systemic chemother...Continue Reading

References

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Aug 19, 2007·The New England Journal of Medicine·Ben SlotmanUNKNOWN EORTC Radiation Oncology Group and Lung Cancer Group
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Mar 5, 2010·International Journal of Radiation Oncology, Biology, Physics·Lawrence B MarksAndrew Jackson

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Citations

Oct 4, 2011·The Oncologist·Tanya B Dorff, Mitchell E Gross
Feb 25, 2015·Ecology and Evolution·Stephanie G YelenikCarla M D'Antonio
Jun 7, 2011·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Neha P AminLaurie E Gaspar

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