INDICATIONS, RESULTS AND TECHNIQUES OF RADIOTHERAPY IN THE TREATMENT OF SMALL-CELL LUNG-CANCER

Aims and background: To define the role of radiotherapy in the treatme nt of small-cell lung cancer (SCLC) on the basis of clinical data repo rted in the medical literature. Methods: Published reports are critica lly reviewed, with particular attention to randomized trials, Results: Thoracic radiotherapy has an important role in improving local contro l and 3-year survival in limited-stage SCLC; radiation should be deliv ered early in the course of the chemotherapy program, avoiding large v olumes and total doses exceeding 40-50 Gy,Thoracic radiotherapy probab ly has no role in resected patients treated with adjuvant chemotherapy and may even be detrimental in patients with extensive SCLC. Prophyla ctic cranial irradiation has been shown to reduce the risk of brain re lapse, but it is not associated with a consistent increase in survival or cure rate: its use in clinical practice is therefore not advised, Conclusions: Survival rates approaching 50% at 2 years are now possibl e in limited SCLC with the integrated effort of the surgeon, the medic al oncologist and the radiation oncologist; their strict cooperation a ppears to be of the utmost importance in the earliest phase of treatme nt planning.