Therapy of small cell lung cancer in the locally advanced stage

About 20% of the patients with small cell lung cancer (SCLC) are still in a limited stage at the time of diagnosis. As nevertheless small cell lung cancer is usually a systemic disease and due to the tendency of this tumour for rapid metastasis systemic chemotherapy is always indicated. Local control is nevertheless important for the symptoms of the patient, the local recurrence and overall prognosis. Therefore thoracic radiotherapy should be applied early during chemotherapy. At least in patients with a good response to chemotherapy and thoracic radiotherapy prophylactic cranial irradiation is recommended, which reduces the occurrence of cerebral metastases and to some extent prolongs survival of these patients.