Combined treatment for limited small cell lung cancer

Radiation therapy is an important component for the management of limited small cell lung cancer (SCLC) in addition to systemic treatment. The role of surgery is limited for SCLC because of the nature of the disease, which often spreads to regional lymph nodes or spreads distantly. There have been major advances in the treatment of limited-stage SCLC during the past decade because of early application of thoracic radiation therapy (TRT) with concurrent chemotherapy, accelerated TRT, the application of prophylactic cranial irradiation for patients who achieved complete response to concurrent chemotherapy and TRT, and the improvement in supportive care such as discontinuation of tobacco smoking after the diagnosis of SCLC, nutritional support, pain control, granulocyte colony-stimulating factor, erythropoietin, and adequate antibiotics. It is important to select patients with limited SCLC who are able to tolerate concurrent chemotherapy and accelerated TRT.