Combined Modality Treatment of Small Cell Lung Cancer

¹ Professor and Chairman, Department of Radiation Oncolog, University of Maryland Medical School and Medical System, Baltimore; American Cancer Society Professor of Clinical Oncology.

CMT yields the best results in LD-SCLC, but attempts must be taken to decrease added toxicity. To achieve maximum effectiveness, RT most be used early with sufficiently higher doses. The use of angled RT fields and shrinking portals is highly desirable to minimize RT-induced toxicity. Nevertheless, more effective systemic treatment is needed in this disease. The use of RT+CT with etoposide and platinum requires further testing, as well as the alternating approach using split-course RT between early CT cycles. More randomized trials are needed with perhaps better-designed and more standardized therapeutic deliveries. RT has now been restored to the main armamentarium for SCLC and is a very logical alternative to second line CT for chest recurrences when induction CT fails.