Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
Eur Respir J. 2010 Jan;35(1):202-15. doi: 10.1183/09031936.00105009.
Small cell lung cancer (SCLC) is an aggressive lung tumour strongly associated with cigarette smoking, with patients often presenting with metastatic disease at the time of diagnosis. Although SCLC is very chemoradiosensitive and high response rates are obtained with treatment, relapse rates are high and the prognosis remains very poor. In limited-stage SCLC, the overall survival rate has been significantly improved by adding dose-hyperfractionated thoracic radiotherapy and prophylactic cranial irradiation to systemic chemotherapy. In contrast, little progress has been made in the treatment of extensive-stage SCLC (ES-SCLC), apart from the recently documented survival gain by the addition of prophylactic cranial irradiation. First-line therapy in ES-SCLC currently consists of chemotherapy, combining a platinum drug with either etoposide or irinotecan as a possible alternative. New treatments are needed in order to improve the prognosis of ES-SCLC, as median survival with current standard treatment is still only 9-10 months from diagnosis. The present review focuses on the management of ES-SCLC, with special attention to the development of new treatment options.
小细胞肺癌（SCLC）是一种侵袭性肺部肿瘤，与吸烟密切相关，患者在诊断时通常已处于转移性疾病阶段。尽管 SCLC 对放化疗非常敏感，且治疗后能获得较高的缓解率，但复发率较高，预后仍非常差。在局限期 SCLC 中，通过在全身化疗中加入剂量递增胸部放疗和预防性颅脑照射，总体生存率得到了显著提高。相比之下，除了最近有研究表明预防性颅脑照射可提高生存获益外，广泛期 SCLC（ES-SCLC）的治疗进展甚微。ES-SCLC 的一线治疗目前包括化疗，将铂类药物与依托泊苷或伊立替康联合使用，后者可能是一种替代选择。为了改善 ES-SCLC 的预后，需要新的治疗方法，因为目前标准治疗的中位生存期仍仅为诊断后 9-10 个月。本文重点关注 ES-SCLC 的治疗管理，并特别关注新治疗方案的发展。
