Management of Small Cell Cancer: Radiotherapy

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Abstract

Radiotherapy has long been an important treatment modality for the management of small cell anaplastic carcinoma of the lung. Initially its use was largely palliative for the treatment of metastases or the temporary control of symptoms from locoregional disease. More recently, its role as part of the potential curative management of the disease has been extensively investigated. With continuing improvements in chemotherapy, for a disease which most workers regard as disseminated at the time of presentation, the long-term results have been consistently improving over the past decade. Concurrent with this improvement has been a questioning of the traditional role of radiotherapy. Indeed some now believe that it may have little part to play in the routine management of the primary disease. If this point of view is accepted, this still leaves other aspects of its use in combination with chemotherapy as part of the management of disease. These may include the possible use of preoperative radiotherapy; the treatment of metastatic sites of election such as the brain, liver, and adrenals; and its possible use in wide field radiation therapy as a rapid method of controlling disseminated disease. There have been several recent general reviews specifically addressing the problems of radiotherapy in small cell lung cancer (Bleehen 1979; Salazar and Creech 1980; Bleehen et al. 1983).