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Initial Management of Small Cell Lung Cancer (Limited and Extensive Stage) and the Role of Thoracic Radiotherapy and First-Line Chemotherapy

ID: 7-13 Oct 2017
Type of Content: Guidelines & Advice, Clinical
Document Status: Current
Authors:
A. Sun, L.D. Durocher-Allen, P.M. Ellis, Y.C. Ung, J. Goffin, K. Ramchandar, G. Darling, Lung Disease Site Group

Guideline Objective

The objective of this guideline was to make recommendations with respect to thoracic radiotherapy and first-line chemotherapy in the treatment of non-resected patients with small cell lung cancer (SCLC).

Patient Population

In keeping with recommendations from the International Association for the Study of Lung Cancer and Cancer Care Ontario, we have transitioned to the use of TNM staging rather than the Veterans Affairs staging of LS versus ES. The target population for this guideline are adult patients with non-resected LS (stage I, II, and III) and ES (stage IV) SCLC who can safely receive definitive radiation.

Intended Guideline Users

Clinicians involved in the treatment of non-resected adult patients with LS (stage I, II, and III) and ES (stage IV) SCLC.

Research Questions

  1. For non-resected patients with ES SCLC, what are the benefits and harms in terms of overall survival, quality of life, and toxicity for chemotherapy and thoracic radiotherapy versus chemotherapy alone?
  2. For non-resected patients with LS SCLC or ES SCLC undergoing chemotherapy, what are the benefits and harms in terms of overall survival, quality of life, and toxicity for early versus late thoracic radiotherapy?
  3. For non-resected patients with LS SCLC or ES SCLC undergoing chemotherapy, what are the benefits and harms in terms of overall survival, quality of life, and toxicity for sequential versus concurrent thoracic radiotherapy?
  4. For non-resected patients with LS SCLC or ES SCLC, what is the optimal dose and schedule of radiation with respect to overall survival, quality of life, and toxicity?
  5. For non-resected patients with LS SCLC or ES SCLC, are there differences in the relative benefits and harms of chemotherapy combinations studied?
  6. For non-resected patients with LS SCLC or ES SCLC, what is the optimal dose and schedule of chemotherapy with respect to overall survival, quality of life, and toxicity
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