Combined modality treatment with chemotherapy and radiotherapy for limited-stage small-cell lung cancer

The cornerstone of treatment for small-cell lung cancer is cisplatin-based combination chemotherapy. Meta-analysis of several randomized trials demonstrated that combined modality treatment with chemotherapy and thoracic radiotherapy increases survival of patients with limited-stage small-cell lung cancer. Early timing of twice-daily thoracic radiotherapy combined with cisplatin and etoposide showed the best results. Prophylactic cranial irradiation is recommended for patients who achieved complete remission with chemoradiotherapy. A randomized trial comparing etoposide and cisplatin with irinotecan and cisplatin following etoposide and cisplatin plus concurrent accelerated hyperfractionated thoracic irradiation for limited-stage small-cell lung cancer is ongoing. (author)