Small Cell Lung Cancer

 Small Cell Lung Cancer

Chemotherapy and Radiation Therapy

 For people with small cell lung cancer, regardless of stage, chemotherapy is an essential part of treatment. Radiation treatment may be used as well depending on the stage of cancer.

In the earliest stages of non-small cell lung cancer, chemotherapy is sometimes given before surgery to reduce tumor size and eliminate early spreading. Doctors call this approach neoadjuvant chemotherapy. For patients with limited lymph node involvement, chemotherapy can also be given post-surgery to kill any remaining cancer cells. This is known as adjuvant chemotherapy and helps prevent the chance of cancer recurrence.

For people with limited-stage small cell lung cancer, combination chemotherapy plus radiation therapy given at the same time is the recommended treatment. The most commonly used initial chemotherapy regimen is etoposide (Toposar or Vepesid) plus cisplatin (Platinol), known as EP.

For later stage cancers when surgery is no longer an option, chemotherapy is often administered with simultaneous radiation therapy. Known as combined chemoradiation therapy, this option often boasts survival rates higher than either treatment given alone or one after the other. This treatment is common if the cancer has spread to the mediastinal lymph nodes, which are located outside of the lung near the trachea and esophagus.

For people with extensive-stage small cell lung cancer, chemotherapy alone using the EP regimen is the standard treatment. However, another regimen that may be used is carboplatin (Paraplatin) plus irinotecan (Camptosar)

Radiation therapy of the brain may be used before or after chemotherapy for some people whose cancer has spread to the brain.

Preventive Radiation Therapy to the Brain

In more than half of the people with small cell lung cancer, the cancer also spreads to the brain. For people whose lung cancer has responded to chemotherapy, doctors may prescribe radiation therapy to the brain to help prevent the cancerfrom spreading to the brain. This procedure is known as prophylactic cranial irradiation (PCI). This can benefit patient with both limited-stage and extensive-stage small cell lung cancers.

Three-dimensional conformal radiation therapy delivers radiation beams tailored to the size, shape, and location of the cancer. Using a linear accelerator, the oncologist aims radiation beams at the cancer from different directions. Treatment is typically done twice a day, five days a week, over the course of three weeks. Breaking the total dose of radiation into smaller doses, called fractions, provides enough therapy to manage the tumor, while reducing the risk of side effects.

NYU Langone physicians use several different approaches for external beam radiation therapy, which is delivered using a machine called a linear accelerator. This machine can be moved around you during treatment sessions, helping oncologists to target the entire tumor. These approaches have different degrees of targeting, and our doctors can talk to you about the best treatment option for you.