Small Cell Lung Cancer
SCLC accounts for 15–20% of lung cancer cases with decreasing incidence. Approximately 1/3 of patients present with limited stage disease and the remainder present with extensive stage disease. More than 95% of cases are associated with a history of tobacco exposure. Ten to 15% of patients present with brain metastases and 2 year incidence after chemo-RT is 50–80%. SCLC is the most common solid tumor associated with paraneoplastic syndromes: SIADH, ACTH production syndrome, and Eaton–Lambert syndrome. Histopathologic hallmarks include dense sheets of small, round to fusiform cells with scant cytoplasm, extensive necrosis, and a high mitotic rate. Pathologic subtypes (pure or classic, variant, and mixed) carry the same prognosis. Most important prognostic factors are stage and performance status.
KeywordsBrain Metastasis Lung Cancer Case Prophylactic Cranial Irradiation High Mitotic Rate Common Solid Tumor
- Auperin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med 1999; 341:476-484.Google Scholar
- Chang JY, Bradley JD, Govindan R, Komaki R. Lung. In: Halperin EC, Perez CA, Brady LW, et al., editors. Principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 1076-1108.Google Scholar
- Komaki R, Travis EL, Cox JD. The Lung and Thymus. In: Cox JD, Ang KK, editors. Radiation oncology: rationale, technique, results. 8th ed. St. Louis: Mosby; 2003. pp. 399-427.Google Scholar
- Komaki R, Paulus R, Ettinger DS, Videtic GM, Bradley JD, Glisson BS, Choy H. A phase II study of accelerated high-dose thoracic radiation therapy (AHTRT) with concurrent chemotherapy for limited small cell lung cancer: RTOG 0239. J Clin Oncol 2009;27:7s (suppl; abstr 7527).Google Scholar
- Le Pechoux C, Dunant A, Senan S, et al. Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99-01, EORTC 2203-08004, RTOG 0212, and IFCT 99-01): a randomised clinical trial. Lancet Oncol 2009;10:467-474.PubMedCrossRefGoogle Scholar
- National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer. Available at: http://www.nccn.org/professionals/physician_gls/PDF/sclc.pdf. Accessed on May 19, 2009.
- Rosenzweig KE, Krug LM. Tumors of the Lung, Pleura, and Mediastinum. In: Leibel SA, Phillips TL, editors. Textbook of radiation oncology. 2nd ed. Philadelphia: Saunders; 2004. pp. 779-810.Google Scholar
- Schild SE, Curran WJ. Small Cell Lung Cancer. In: Gunderson LL, Tepper JE, et al., editors. Clinical radiation oncology, 2nd ed. Philadelphia: Churcill Linigstone; 2007. pp. 897-909.Google Scholar