[Limited stage small cell lung cancer]

Recent progress in the treatment of limited stage small cell lung cancer (LD-SCLC) is reviewed. SCLC represents 15-20% of all lung cancers. Combination chemotherapy is considered the treatment of choice because SCLC usually is widespread at diagnosis. The PE (CDDP + Etoposide) regimen and concurrent thoracic irradiation have yielded the best survival results in LD-SCLC. Although the timing of chemotherapy and thoracic radiation is still controversial, the early integration of chemotherapy and thoracic irradiation produces a small survival advantage over the late integration of chemoradiotherapy. Radiotherapy should be delivered to a smaller target volume based on CT planning, and twice-daily chest irradiation (accelerated hyperfractionation) is recommended because of improvement in local control and survival. Meta-analysis has shown that prophylactic cranial irradiation reduced the rate of brain metastases and increased 3-year survival by 5% in patients with SCLC in complete response.