Small cell lung cancer (sclc) is a highly malignant tumor. Lung cancer has a unique recalcitrant symptoms. In recent years, due to chemotherapy drugs, programs, innovative methods to chemotherapy, and multidisciplinary treatment in sclc made great progress in the long-term survival rate than in the past has greatly improved. Of limited (ld) sclc the most effective treatment is pe (cisplatin + vp16) synchronous brain radiotherapy (trt). A wide range of (ed) sclc solution ip (irinotecan + cisplatin) than pe. Surgery can also extend the sclc survival of patients and survival.
Small cell lung cancer to systemic chemotherapy must be based. Because of poor biological behavior of small cell lung cancer, fast growth, short doubling time (doubling time of tumor increased 21-30 days), and high malignancy, transfer fast and extensive. About 90% of the time of diagnosis has the potential of Thoracic and presence of distant micro-metastasis, which is the most common mediastinal shift, followed by liver, bone, bone marrow, brain and other distant metastases, it should be based on systemic therapy. Because of small cell lung cancer the extent of disease, location is different from chemotherapy in the comprehensive treatment in the order and importance should also be different.
Because most of the patients at the time of diagnosis has been associated with lymph node or distant metastases and no surgical treatment of lung cancer symptoms, very few small-cell lung cancer staging by TNM staging, according to focus simply into the range of limited and extensive period. unfavorable prognostic factors include a wide range of disease, LDH values increased, poor performance status score weight loss, and male gender. limited small cell lung cancer should be 4 to 6 cycles of EP solution [(etoposide, VP- 16) + cisplatin (DDP)] chemotherapy and thoracic radiation therapy over the same period. a wide range of diseases with systemic chemotherapy, and, programs and more use of VP-16 combined with cisplatin or carboplatin. even for the elderly or poor performance status score patients, combination chemotherapy is still recommended.
Small cell lung cancer treatment, radical surgical resection is not IIB, or IV of the induction period should be chemotherapy (neoadjuvant chemotherapy) further local radiotherapy (sequential therapy), radiotherapy has long been proved wrong, unless there is some special syndrome as above vena cava syndrome, radiotherapy can markedly. Bureau of limited small cell lung cancer treated with radiotherapy at the same time the complementary effect (simultaneous control of intrathoracic lesions and distant micrometastasis) received wide attention and recognition. But the best radiation dose, chemotherapy doses remain to be resolved.
IV of the chemotherapy, and chemotherapy in selected according to specific circumstances, such as metastasis of bone metastases for palliative radiotherapy, or liver intervention. N to overcome drug resistance of small cell lung cancer, had randomly alternating chemotherapy with chemotherapy compared with single, the former only a slight improvement in median survival (4 – 6 weeks), per long-term survival advantage, as small-cell lung cancer with high dose Chemotherapy and bone marrow stem cell therapy, since the 20th century, 70 years accumulated a large amount of clinical research data, but so far (2004) internationally whether this treatment is superior to conventional chemotherapy surviving controversial, and expensive, so not recommended for routine use.
Small cell lung cancer, postoperative adjuvant chemotherapy should be the line, III period (mediastinal lymph node metastasis) resectability should be the general preoperative chemotherapy (neoadjuvant chemotherapy), adjuvant chemotherapy after the operation and local radiotherapy, the current I, II of small cell lung cancer also called for neoadjuvant chemotherapy to try to control the clinical element of any performance of micrometastases.
- extra pulmonary manifestation of lung cancer