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Concurrent Radiation Therapy and Chemotherapy for SCLC

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According to an article recently published in the British Journal of Cancer, chemotherapy including Paraplatin® (carboplatin), Taxol® (paclitaxel), and Vepesid® (etoposide) plus radiation therapy delivered at the same time is an effective treatment regimen for limited small cell lung cancer.

Small cell lung cancers (SCLC) account for 20-25% of all lung cancers and are primarily diagnosed in smokers or former smokers. They differ from other types of lung cancer in that they spread very quickly throughout the body via the blood and lymphatic system.

Limited SCLC is confined to a single location in the chest and is not detectable outside the lung. The combination of chemotherapy and radiation therapy has improved survival for patients with limited-stage SCLC, but long-term survival remains poor. Researchers continue to look for the optimal approach to treatment.

Researchers from Holland recently conducted a clinical trial to evaluate chemotherapy plus radiation therapy in the treatment of limited SCLC. This trial included 38 patients who were treated with carboplatin, paclitaxel, etoposide, and concurrent radiation (given at the same time as chemotherapy). Patients also received prophylactic radiation therapy to the brain to prevent the development of cancer metastasis (spread) to the brain.

Anticancer responses were experienced by 91% of patients.

Median survival time was 19.5 months.

At one year, the overall survival rate was 70%.

At 5 years, the overall survival rate was 27%.

Metastasis to distant sites in the body occurred in 50% of patients, with the majority being to the brain.

Severe side effects were common.

The researchers concluded that carboplatin/paclitaxel/etoposide and concurrent radiation therapy provides encouraging 5-year survival rates for patients with limited SCLC. Unfortunately, prophylactic radiation therapy to the brain did not prevent the development of metastasis to the brain in the majority of patients who developed metastases.

Patients diagnosed with SCLC may wish to speak with their physician regarding this treatment approach, or their individual risks and benefits of participating in a clinical trial evaluating other new therapeutic approaches to improve survival for this disease. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Baas P, Belderbos JSA, Senan S, et al. Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: A Dutch multicenter phase II trial. British Journal of Cancer. 2006;94:625-630.

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