Rationale:Patients with extensive small cell lung cancer (SCLC) generally have a dismal survival rate and are conventionally treated with chemotherapy. This study aimed to explore an alternative treatment approach by combining traditional Chinese medicine (TCM) with radiotherapy and chemotherapy.Patient concerns:A 68-year-old male was diagnosed with extensive-stage SCLC. Positron emission tomography/computed tomography scans indicated a high metabolism mass in the left hilar region, along with multiple lymph node metastases and metastatic tumors in both lungs. A left lung biopsy verified small cell carcinoma.Diagnoses:The patient was confirmed to have extensive stage SCLC based on imaging and biopsy results.Interventions:The patient received a comprehensive treatment regimen. TCM herbal prescriptions such as Qianjin Weijing Decoction, Wuwei Xiaodu Decoction, Xiaoxianxiong Decoction, and Xiaochengqi Decoction were administered. In parallel, standard Western medicine therapies, including chemotherapy (intravenous cisplatin and etoposide) and radiotherapy, were carried out. Oral ondansetron was given to alleviate nausea and vomiting caused by chemotherapy and radiotherapy.Outcomes:After 30 months, follow-up positron emission tomography/computed tomography demonstrated the complete disappearance of all cancerous lesions. The patient regained normal daily activities and experienced a substantially enhanced quality of life. Four years after the initial treatment, there has been no recurrence, and the patient persists in taking the original TCM decoction.Lessons:The combination of TCM and Western medicine in treating SCLC proves effective in managing systemic symptoms, mitigating bone marrow suppression, gastrointestinal reactions, immunosuppression, and other chemotherapy-induced adverse reactions. It also significantly prolongs the survival period, suggesting it as a preferable treatment option for SCLC.