title: Current and evolving treatment options for limited stage small cell lung cancer.
abstract: OBJECTIVE
  About one-third of small cell lung cancer cases are classified as limited stage. Trials have attempted to establish the most effective, least toxic regimen of combined modality treatment. Recently, issues like the role of the positron emission tomography scan, elderly patient management and the timing and delivery of radiotherapy have been addressed. Several targeted agents have also been evaluated. This review will highlight the data that have greatly impacted on the standard of limited stage small cell lung cancer care.
  
  
  RESULTS
  Trials have concluded that small cell lung cancer is fluorodeoxy-D-glucose avid and that positron emission tomography has potential for utility in staging and radiation therapy planning, though it is not recommended. Recent trials confirm no benefit to adding chemotherapeutic agents to standard cisplatin and etoposide. To date, all targeted therapies have failed to show impressive results. Two analyses of outcomes in elderly patients argue that combined modality therapy should be considered, with patients carefully monitored. Two meta-analyses demonstrate thoracic radiotherapy should be delivered, with increased dose and schedule intensity.
  
  
  CONCLUSIONS
  Current data demonstrate that combined modality therapy with early administration of thoracic radiotherapy remains the care standard in limited stage small cell lung cancer care. Cisplatin and etoposide continue to be the chosen cytotoxic agents. Targeted therapies and advances in the radiotherapy technological aspects represent opportunities for improved outcomes in the future management of this aggressive disease.
authors.affiliation: Multidisciplinary Thoracic Oncology Program, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, 27599, USA.
authors.forename: Carrie B
authors.initials: CB
authors.lastname: Lee
authors.forename: David E
authors.initials: DE
authors.lastname: Morris
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Fried
authors.forename: Mark A
authors.initials: MA
authors.lastname: Socinski
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011878:Radiotherapy / Q000379:methods