General Information About Small Cell Lung Cancer
Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.)
Related Summaries
Non-Small Cell Lung Cancer: Advances in Chemotherapy
Chemotherapy is being used in new ways to treat non-small cell lung cancer (NCSLC). Until a few years ago, only patients with late-stage lung cancer received chemotherapy to help prolong life. Now, chemotherapy is given at earlier stages, in addition to other treatments, to slow the progression of cancer and to help cure the disease. “Chemotherapy has dramatically improved in the last decade,” says George R. Simon, MD, FACP, FCCP, director of thoracic oncology Fox Chase Cancer Center in Philadelphia...
Read the Non-Small Cell Lung Cancer: Advances in Chemotherapy article > >
Note: Other PDQ summaries containing information related to lung cancer include the following:
- Lung Cancer Prevention
- Lung Cancer Screening
- Non-Small Cell Lung Cancer Treatment
Incidence and Mortality
Note: Estimated new cases and deaths from lung cancer (small cell lung cancer and non-small cell lung cancer combined) in the United States in 2010:[1]
- New cases: 222,520.
- Deaths: 157,300.
Small cell lung cancer (SCLC) accounts for approximately 15% of bronchogenic carcinomas. The overall incidence and mortality rates of SCLC in the United States have decreased during the past few decades.[2] Without treatment, SCLC has the most aggressive clinical course of any type of pulmonary tumor, with median survival from diagnosis of only 2 to 4 months. Compared with other cell types of lung cancer, SCLC is more responsive to chemotherapy and radiation therapy; however, a cure is difficult to achieve because SCLC has a greater tendency to be widely disseminated by the time of diagnosis. It is the cancer most commonly associated with paraneoplastic syndromes, including the syndrome of inappropriate antidiuretic hormone secretion, paraneoplastic cerebellar degeneration, and Lambert-Eaton myasthenic syndrome.[2]
Limited-Stage Disease
At the time of diagnosis, approximately 30% of patients with SCLC will have tumors confined to the hemithorax of origin, the mediastinum, or the supraclavicular lymph nodes. These patients are designated as having limited-stage disease (LD), and most 2-year disease-free survivors come from this group. For patients with LD, median survival of 16 to 24 months and 5-year survivals of 14% with current forms of treatment have been reported.[3,4,5,6] Patients diagnosed with LD who smoke should be encouraged to stop smoking before undergoing combined-modality therapy because continued smoking may compromise cure rates.[7]
Improved long-term survival has been shown with combined modality therapy.[6,8][Level of evidence: 1iiA] Although long-term survivors have been reported among patients who received either surgery or chemotherapy alone, chemotherapy combined with thoracic radiation therapy (TRT) is considered the standard of care.[9] Adding TRT increases absolute survival by approximately 5% over chemotherapy alone.[8,10] The optimal timing of TRT relative to chemotherapy has been evaluated in multiple trials and meta-analyses with the weight of evidence suggesting a small benefit to early TRT.[4,11,12][Level of evidence: 1iiA] Prophylactic cranial radiation prevents central nervous system (CNS) recurrence and can improve survival in patients who have had a complete response to chemoradiation.[13,14][Level of evidence: 1iiA]
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