Chemotherapy Because of the frequent presence of hidden and undetectable spread to other parts
of the body, chemotherapy is the cornerstone of treatment for small cell lung cancer, since it also treats tumors too small to detect. Once remission is achieved, there is no evidence that maintenance therapy is beneficial. There is little evidence that more than six months of treatment is of value.
Radiation Radiation to the primary tumor site and regional lymph nodes is commonly given to
patients with limited disease. Moderate doses (3,500 to 4,500 cGy) are usually recommended, but the dose administered must be individually selected based on tumor volume, location, lung function and other factors. The administration of radiation therapy with chemotherapy does improve the local tumor response rate, long-term local control and overall survival. The best results appear to occur when radiotherapy is given early in the course of treatment and when radiation is given concurrent with chemotherapy. These latter approaches can be associated with increased local side effects (esophagitis and lung fibrosis) as well as bone marrow depression.
Some patients have a tumor mass in the center of the chest that presses on the large vein draining blood from the head and arms (the superior vena cava). This pressure causes a fluid backup, resulting in swelling of the face and arms and sometimes even the brain. If this superior vena cava syndrome is present, combination chemotherapy alone can be given or radiation therapy given with it.
