Treatment and prognosis of small-cell lung cancer

Chest CT scan shows a central mass with adenopathy confirmed as small cell carcinoma.



Small cell lung cancer (SCLC) occurs almost exclusively in cigarette smokers. Although SCLC is highly responsive to chemotherapy and radiation therapy, it usually relapses within months depite treatment.

Choice of treatment, prognosis depend on disease staging at the time of diagnosis. Veterans' Affairs Lung Study Group has recommended a simple and clinically useful staging system:

• Limited-stage SCLC is defined as disease confined to ipsilateral hemithorax, meaning to the same side of the chest


• Extensive-stage SCLC is defined as disease extending outside the ipsilateral hemithorax

Without treatment, patients with SCLC survive only a few months. With chemotherapy or radiotherapy, survival is significantly prolonged.

• 80-90 percent of patients with limited-stage disease respond to chemotherapy plus radiation therapy


• 60-80 percent with extensive-stage disease respond to chemotherapy


• chest radiotherapy is usually for those with limited-stage disease


• median duration of responses is 6-8 months


• median survival for limited-stage disease is 14-20 months, extensive-stage disease 8-13 months