Treatment of relapsed small cell lung cancer

Small cell lung cancer is a frequently relapsing tumor despite a high rate of response after first-line chemotherapy. For these patients, treatment at relapse depends on the response to first-line treatment, time off therapy, and the site of progression. For patients with a good performance status and a relapse more than 3 months after first-line treatment, the choice of chemotherapy at relapse is the same as initial therapy. In case of earlier progression, so-called non-cross-resistant chemotherapy should be given. For symptomatic metastases in bone or brain, radiotherapy usually gives temporary palliation. For intrathoracic relapse and severe obstruction of main bronchus and/or superior caval vein, radiotherapy is a possibility if not given as part of first-line treatment. Semin Oncol 28 (suppl 4):48-52.