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 Doses in the range of 4,000 to 5,000 cGy or more are needed to control chest tumors
effectively. If radiation therapy is given with combination chemotherapy , there are higher response rates and better survival than when radiation therapy is given alone. Radiation therapy plus combination chemotherapy is also superior to chemotherapy alone for controlling the primary chest tumor, but there is no evidence that this approach provides better control for metastatic disease.
Studies have shown some survival benefit when combined therapy is given, especially in limited disease, so long as radiation therapy does not result in a delay of the administration of proper doses of chemotherapy. There are increased side effects with combined programs, and some treatment-related mortality because of lung and bone marrow toxicities.
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.
