Treatment of limited-stage small cell lung cancer: recent progress and future directions

Abstract

Small cell lung cancer (SCLC) is a common, largely preventable malignancy seen almost exclusively in smokers. Since the late 1960s, it has been recognized that SCLC is a systemic process that is not curable with surgery or thoracic radiotherapy alone. Accordingly, these patients are typically treated with combination chemotherapy irrespective of stage at diagnosis. Unfortunately, patients with extensive stage disease are rarely cured, even with aggressive treatment. On the other hand, patients with limited-stage disease sometimes experience long-term progression-free survival with chemotherapy with or without thoracic radiotherapy. Of the more than 40 000 cases of SCLC that will be diagnosed in the United States in 1992, approximately 25–50% will have limited-stage disease. Thus, as many as 20 000 patients have a potentially curable malignancy. Definite progress has been made in the treatment of limited-stage SCLC.