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Oncología (Barcelona)

Print version ISSN 0378-4835


COBO DOLS, M. et al. Updating the systemic treatment of lung microcytic carcinoma. Oncología (Barc.) [online]. 2005, vol.28, n.10, pp.10-25. ISSN 0378-4835.

Among patients with lung cancer, the proportion of those with small cell lung cancer (SCLC) type has decreased over the last decade. Staging of SCLC considers a limited disease and an extensive disease. Limited disease stage is treated for curative intent by chemotherapy and radiation therapy, with a median survival time of approximately 18 months. Extensive disease stage is treated primarily by chemotherapy, with a high initial response rate of 60 to 70% and a complete response rate of 20 to 30%, but with a median survival time of approximately 9 months. This review poses several questions about the systemic treatment of SCLC, based on medical evidence, but making a critical overview. In both, extensive and limited stages of SCLC, a combination of several drugs is administered in doses associated with at least moderate toxic effects in order to produce the best results. Platinum-based chemotherapy remains the treatment mainstay in both cases. Currently, a clear benefit of dose intensity or maintenance, or of association with bone marrow transplantation has not been observed in SCLC patients. However, the strategy of chemotherapy densification by shortening the cycle intervals has shown a survival increase in four randomized trials. Third generation drugs combined with cisplatin are possible treatment options, but they have not shown any survival advantage to date when compared with the standard combination of cisplatin and etoposide. Relapsed or refractory SCLC have a uniformly poor prognosis, being topotecan the treatment of choice. Drugs with new therapeutic targets are promising, but they have not either shown a betterment of survival to date.

Keywords : Small cell lung cancer; SCLC; Chemotherapy.

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