A previously well 54-year old woman with a three-month history of weight loss and recurring chest infections is found to have a left hilar mass on chest x-ray.bronchoscopy and biopsy reveal small cell carcinoma.All staging investigations are normal,suggesting disease is confined to the lung.which one of the following treatment strategies is most appropriate? 1) left pneumonectomy 2) pre-operative radiation therapy followed by pneumonectomy 3) radiation therapy to the chest 4) chemotherapy followed by left pneumonectomy 5) chemotherapy and radiation therapy to the chest
Justice Forum Fanatic
Topics: 107 Posts: 2,157
03/29/07 - 02:21 PM
#2
Although they say that distant mets in SCLC are present at the time of diagnostics, I would offer (4) to this Pt ___________________ Don't live in a town where there are no doctors
NE Forum Guru
Topics: 53 Posts: 504
03/29/07 - 02:55 PM
#3
5- small cell carcinoma - chemo+ radio
Justice Forum Fanatic
Topics: 107 Posts: 2,157
03/29/07 - 03:18 PM
#4
I had two pt in the past with SCLC, and they both died of post-radiation miocarditis and acute cardiopulmonary failure... This is a hilar tumor on the left side, and the chance to have the heart irradiated is 100%... At the same time, if tumor recurres, it comes back from the original site... Older colleagues told that if you can remove the tumor,-do that + mediastenal LN... I don't claim that Chest irradiation isn't a treatment chioce, But in this particular case the lung can be removed with the tumor bcz "...disease is confined to the lung..."... And only after ChT... Will be glad to hear other practical opinions Edited by Justice on 03/29/07 - 04:44 PM
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doc_clotaire Forum Guru
Topics: 159 Posts: 1,247
03/29/07 - 07:16 PM
#5
According to Kaplan , you don ' t usually do surgery for SCLC , just treat them with chemo and radio
5 )
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AAAAA Forum Fanatic
Topics: 156 Posts: 1,991
03/29/07 - 09:05 PM
#6
5
The correct answer is 5
Never do surgert on SCLC because micrometastsis already occured and no use to do surgery.
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AAAAA Forum Fanatic
Topics: 156 Posts: 1,991
03/29/07 - 09:06 PM
#7
AAAAA wrote: 5
The correct answer is 5
Never do surgery on SCLC because micrometastsis already occured and no use to do surgery.
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