Morabito Alessandro, Carillio Guido, Daniele Gennaro, Piccirillo Maria Carmela, Montanino Agnese, Costanzo Raffaele, Sandomenico Claudia, Giordano Pasqualina, Normanno Nicola, Perrone Francesco, Rocco Gaetano, Di Maio Massimo
Medical Oncology Unit, Thoraco-Pulmonary Department, Istituto Nazionale Tumori, "Fondazione G. Pascale" - IRCCS, Napoli, Italy.
Department of Oncology and Hematology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
Crit Rev Oncol Hematol. 2014 Sep;91(3):257-70. doi: 10.1016/j.critrevonc.2014.03.003. Epub 2014 Apr 2.
Treatment of small cell lung cancer (SCLC) remains a significant challenge for the oncologists. Attempts to improve the results of first-line treatment have all failed so far and no real progress has been made in last years, emphasizing the need for novel strategies of treatment and the development of validated biomarkers. Patients with limited disease and good performance status should be considered for concomitant chemoradiotherapy, followed by prophylactic cranial irradiation. Patients with extensive disease should be treated with a platinum-based chemotherapy (cisplatin or carboplatin); chest radiotherapy can be considered in patients achieving extra-thoracic complete response and prophylactic cranial irradiation is recommended for patients responsive to initial chemotherapy. A large number of molecular-targeted drugs and immunomodulators are currently in clinical development: however, only a better understanding of molecular biology of SCLC and the identification of molecular markers predictive of response to targeted agents will lead to advances in the treatment of SCLC.
小细胞肺癌（SCLC）的治疗仍然是肿瘤学家面临的重大挑战。迄今为止，所有改善一线治疗效果的尝试均告失败，且在过去几年中未取得实质性进展，这凸显了新型治疗策略以及经过验证的生物标志物开发的必要性。对于疾病局限且身体状况良好的患者，应考虑同步放化疗，随后进行预防性颅脑照射。对于广泛期疾病患者，应采用铂类化疗（顺铂或卡铂）；对于胸外达到完全缓解的患者可考虑胸部放疗，对于对初始化疗有反应的患者推荐进行预防性颅脑照射。目前大量分子靶向药物和免疫调节剂正处于临床开发阶段：然而，只有更好地理解SCLC的分子生物学并鉴定出预测靶向药物反应的分子标志物，才能推动SCLC治疗取得进展。
