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EDITORIAL Small-Cell Lung Cancer, Getting Smaller But Still Difficult to Treat Craig P. Carden, MBBS, FRACP, and Mary E. R. O’Brien, MD, FRCP lthough small-cell lung cancer (SCLC) is chemosensitive, relapses invariably occur Aand the median survival remains at best 14.5 months for limited stage and 8.4 months for extensive stage disease. Response rates to second-line chemotherapy are higher if relapse occurs after a long period since first line therapy. Thus there is general nihilism about second-line treatment for relapsed SCLC. Even in the first line setting attempts to improve response rates and survival by adding new chemotherapeutic agents, giving chemotherapy for longer, at higher doses, or even with stem-cell support have all proved discouraging. A couple of recent reported positive studies have therefore been welcomed. The publication of a trial in patients with extensive stage small-cell lung cancer showed that the use of prophylactic cranial irradiation after chemotherapy decreased the incidence of brain metastases and gave a survival and symptomatic benefit, (with a 1 year survival rate of 13.3% in the control group compared with 27.1% in the treated group, (p 0.003, HR0.68)). This has come as something of a surprise, suggesting that the more of this
Journal of Thoracic Oncology – Wolters Kluwer Health
Published: Feb 1, 2008
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