Treatment options for small cell lung cancer.
Lung cancer remains the leading cause of cancer-related death in the United States. Small cell lung cancer (SCLC) comprises 15% to 25% of all lung cancers. The leading cause of lung cancer remains smoking, and rates of smoking continue to rise in women, whereas rates in other subgroups have slowed. In this article we review recent advances in the treatment of limited-stage as well as extensive-stage small cell lung cancer. In limited-stage disease, the best survival results are observed when patients are treated with twice-daily thoracic radiotherapy given concurrently with chemotherapy. Patients who have been successful in smoking cessation during therapy for limited-stage disease may have a survival benefit over those who are unable to quit smoking during treatment. In extensive-stage disease, the most significant trial is one comparing irinotecan plus cisplatin and etoposide plus cisplatin, showing a survival advantage for the irinotecan arm. This trial may change the standard of care for patients with extensive-stage disease. A similar ongoing trial in the United States is attempting to confirm these results.
Wolf
Todd
T
Division of Hematology and Oncology, University of Virginia, Box 800716, 6th Floor Multistory Building, Room 6007, Charlottesville, VA 22908, USA.
Gillenwater
Heidi H
HH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001549:Benzamides; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D009367:Neoplasm Staging; D010879:Piperazines / Q000008:administration & dosage; D019009:Proto-Oncogene Proteins c-kit / Q000187:drug effects; D011743:Pyrimidines / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D005047:Etoposide; D000077146:Irinotecan; D004317:Doxorubicin; D000068877:Imatinib Mesylate; D003520:Cyclophosphamide; D019009:Proto-Oncogene Proteins c-kit; D002945:Cisplatin; D002166:Camptothecin