Overview of comprehensive knowledge of small cell lung cancer

Small cell lung cancer often occurs in the bronchi, seriously endangering people's respiratory system. Due to the serious pollution of the current living environment, the air is bad when people travel. Do you know the comprehensive knowledge overview of small cell lung cancer? Let us learn about the comprehensive knowledge overview of small cell lung cancer.

Small cell lung cancer (SCLC) is an aggressive disease, accounting for about 15% of all lung cancers. It has a low degree of differentiation, a high degree of malignancy, and a short doubling time (i.e., it progresses very quickly). Without chemoradiotherapy, the prognosis is very poor, with an average of about 3-6 months. However, another characteristic of small cells is that they are very sensitive to chemoradiotherapy, that is, the treatment effect of chemoradiotherapy is very good, and the initial objective remission rate is much higher than that of other lung cancers. Therefore, standardized chemoradiotherapy can greatly improve the survival time of patients. The third characteristic of small cell lung cancer is based on the good effect of initial chemoradiotherapy, that is, the late recurrence (progression) rate is high, so the overall situation is not optimistic, with a 5-year (or more) survival rate of only about 6%. In other words, most (about 94%) patients have an overall survival of between 0.5 and 5 years after chemoradiotherapy.

Incidence: The incidence of small cell lung cancer accounts for about 15-20% of the total lung cancer. Due to its high malignancy and easy hematogenous metastasis, most of them are already in the extensive stage when diagnosed. Although it is sensitive to chemotherapy, it is easy to develop drug resistance, which makes treatment difficult.

Diagnostic method: Pathological or cytological diagnosis can confirm the diagnosis (some difficult to diagnose cases require combined immunohistochemical staining to assist in differential diagnosis).

Staging examination: The purpose is to understand whether the patient has distant metastasis and guide treatment.

Examination contents: cranial MRI (enhanced), whole-body bone scan, cervical and supraclavicular lymph node ultrasound, abdominal ultrasound, chest enhanced CT. Whole-body PET-CT examination can be used for screening, but it needs to be combined with cranial MRI (PET-CT is prone to miss brain metastases). Some PET high-metabolism lesions need other examinations to help clarify their nature.

Treatment principles:

Limited stage: Treatment is mainly synchronous or sequential chemoradiotherapy, with an effective rate of 70-90%.

Extensive stage: Systemic chemotherapy is the main treatment, and the EP regimen has an efficacy of 60-70%. Depending on the patient's symptoms, local treatment can be combined with some metastatic lesions to control symptoms.

Follow-up after treatment: Follow-up every 3-4 months in the first 1-2 years after treatment, every 6 months in the third to fifth years, and once a year after 5 years. Follow-up includes: blood test, physical examination, chest enhanced CT, and cranial MRI and bone scan if necessary.