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This algorithm covers treatment of limited-stage small cell lung cancer, defined as disease confined to one hemithorax that can be encompassed in a tolerable radiation field. Very limited disease (cT1 to T2 N0) that is resectable is treated with lobectomy followed by adjuvant platinum and etoposide. Other limited-stage disease is treated with definitive concurrent chemoradiation using cisplatin and etoposide with early twice-daily radiotherapy, linked to the Turrisi trial; thoracic radiotherapy should start early, with cycle 1 or 2 of chemotherapy.
After definitive chemoradiation, the chart shows two components. Consolidation durvalumab is supported by ADRIATIC, which improved survival. For the CNS, prophylactic cranial irradiation (PCI) or MRI surveillance is offered, and the choice between them should be discussed with the patient. The overall sequence is therefore multimodality therapy with early concurrent chemoradiation, followed by immunotherapy consolidation and a CNS strategy. This is a simplified board-review scaffold that should be verified against current guidelines and primary literature.
Background reading: Small cell lung cancer (SCLC) board review notes.
Disease confined to one hemithorax / tolerable RT field → multimodality therapy. Starting point: Limited-stage SCLC confined to one hemithorax. Full background: Small cell lung cancer (SCLC) notes.
Simplified board-prep scaffold; verify against current guidelines and primary literature. Start thoracic RT early (with cycle 1-2 of chemo); consolidation durvalumab improved survival (ADRIATIC); discuss PCI vs MRI surveillance.