PT  - JOURNAL ARTICLE
AU  - Huber, Rudolf M.
AU  - Tufman, Amanda
TI  - Update on small cell lung cancer management
AID  - 10.1183/20734735.013211
DP  - 2012 Jun 01
TA  - Breathe
PG  - 314--330
VI  - 8
IP  - 4
4099  - http://breathe.ersjournals.com/content/8/4/314.short
4100  - http://breathe.ersjournals.com/content/8/4/314.full
SO  - breathe2012 Jun 01; 8
AB  - Educational aims To describe the relevance of staging, including TNM staging To show the clinical relevance of paraneoplastic syndromes as a presentation of small cell lung cancer To understand the indications for prophylactic cranial irradiation To describe the treatment principles in small cell lung cancer with emphasis on the relevance of staging To outline the second-line treatment options Summary Small cell lung cancers (SCLCs) account for ∼15–20% of all lung cancers. Because SCLC is almost always associated with long-term tobacco smoking, abstinence from smoking and smoking cessation are crucial for primary prevention. Because symptoms are generally unspecific, the disease is often diagnosed late, with 70% of patients already in stage IIIb or IV at the time of diagnosis. Early detection of SCLC through screening is under investigation. Chemotherapy, generally a platinum-based combination, is the mainstay of therapy and is generally combined with radiation in the first-line treatment of tumours up to stage IIIb. Surgery has a place in the diagnosis and therapy of stage I SCLC, but plays no key role in advanced cancer. In patients who respond to first-line therapy, prophylactic cranial irradiation can prevent brain metastases and improve overall survival. Although the initial response to treatment is usually good, SCLC tends to relapse quickly. This makes second-line therapy quite important. Topotecan is the most studied and widely used agent in second-line therapy; however, newer agents, including biological therapies, are under study.