scholarly journals Small Cell Lung Cancer in Elderly Patients: A Review

2008 ◽  
Vol 6 (3) ◽  
pp. 333-344 ◽  
Author(s):  
Taofeek K. Owonikoko ◽  
Suresh Ramalingam
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Therapeutic Interventions ◽  
Small Cell Lung ◽  
Platinum Based Chemotherapy ◽  
Thoracic Radiation ◽  
Modality Approach

Small cell lung cancer (SCLC) accounts for approximately 13% of all lung cancer cases. Approximately 40% of those cases are diagnosed in patients older than 70 years, and this proportion continues to rise in contrast to the continued decline in incidence of SCLC among the general population. The optimal strategy to manage limited-stage SCLC involves a combined modality approach with platinum-based chemotherapy and external-beam thoracic radiation therapy. For extensive-stage disease, platinum-based combination chemotherapy is a mainstay of therapy. Elderly patients present unique challenges in terms of drug metabolism and organ reserve, which impact the outcome of therapeutic interventions. However, limited data are available to guide management decisions for SCLC in elderly patients, and therefore this article discusses recommendations for treatment.

Systematic Review Evaluating the Timing of Thoracic Radiation Therapy in Combined Modality Therapy for Limited-Stage Small-Cell Lung Cancer

2004 ◽  
Vol 22 (23) ◽  
pp. 4837-4845 ◽  
Author(s):  
Daniel B. Fried ◽  
David E. Morris ◽  
Charles Poole ◽  
Julian G. Rosenman ◽  
Jan S. Halle ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Limited Stage ◽  
Platinum Based Chemotherapy ◽  
Thoracic Radiation ◽  
The Impact

Purpose We employed meta-analytic techniques to evaluate early (E) versus late (L) timing of thoracic radiation therapy (RT) in limited-stage small-cell lung cancer (LS-SCLC). In addition, we assessed the impact of radiation fractionation and chemotherapeutic regimen on timing. Methods Randomized trials published after 1985 addressing timing of RT relative to chemotherapy in LS-SCLC were included. Trials were analyzed by risk ratio (RR), risk difference, and number-needed-to-treat methods. Results Overall survival (OS) RRs for all studies were 1.17 at 2 years (95% CI, 1.02 to 1.35; P = .03) and 1.13 at 3 years (95% CI, 0.92 to 1.39; P = .2), indicating a significantly increased 2-year survival for ERT versus LRT patients and suggestive of a similar trend at 3 years. Subset analysis of studies using hyperfractionated RT revealed OS RR for ERT versus LRT of 1.44 (95% CI, 1.17 to 1.77; P = .001) and 1.39 (95% CI, 1.02 to 1.90; P = .04) at 2 and 3 years, respectively, indicating a survival benefit of ERT versus LRT. Studies using once-daily fractionation showed no difference in 2- and 3-year OS RRs for ERT compared with LRT. Studies using platinum-based chemotherapy had OS RRs of 1.30 (95% CI, 1.10 to 1.53; P = .002) and 1.35 (95% CI, 1.07 to 1.70; P = .01) at 2 and 3 years, respectively, favoring ERT. Studies using nonplatinum-based chemotherapy regimens had nonsignificant differences in OS. Conclusion A small but significant improvement in 2-year OS for ERT versus LRT in LS-SCLC was observed, similar to the benefit of adding RT to chemotherapy or prophylactic cranial irradiation. A greater difference was evident for hyperfractionated RT and platinum-based chemotherapy.

Small Cell Lung Cancer: Advances in Diagnosis and Management

2020 ◽  
Vol 41 (03) ◽  
pp. 435-446
Author(s):  
Ayushi F. Chauhan ◽  
Stephen V. Liu
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Predictive Biomarkers ◽  
Small Cell ◽  
Standards Of Care ◽  
Small Cell Lung ◽  
Early Stage Disease ◽  
Platinum Based Chemotherapy ◽  
Thoracic Radiation

AbstractSmall cell lung cancer (SCLC) is an aggressive subtype of lung cancer characterized by rapid growth and early spread. It is a highly lethal disease that typically is diagnosed at a late stage. Surgery plays a very small role in this cancer, and management typically involves chemotherapy, delivered with thoracic radiation in early-stage disease. Platinum-based chemotherapy is initially very effective, inducing rapid and often deep responses. These responses, though, are transient, and upon relapse, SCLC is highly refractory to therapy. Immunotherapy has shown promise in delivering meaningful, durable responses and the addition of immunotherapy to first-line chemotherapy has led to the first improvements in survival in decades. Still, the disease remains difficult to manage. Incorporating radiation therapy at specific points in patient management may improve disease control. The development of predictive biomarkers and novel targeted therapies will hopefully improve options for patients in the near future. This review focuses on the current standards of care and future directions.

Thoracic radiation therapy could give survival benefit to elderly patients with extensive-stage small-cell lung cancer

2017 ◽  
Vol 13 (13) ◽  
pp. 1149-1158 ◽  
Author(s):  
Changchun An ◽  
Wang Jing ◽  
Yan Zhang ◽  
Sujing Liu ◽  
Haiyong Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Survival Benefit ◽  
Small Cell ◽  
Small Cell Lung ◽  
Thoracic Radiation ◽  
Extensive Stage
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