Chemotherapy is the mainstay treatment for limited-stage SCLC. 80-90% of cases of limited stage SCLC achieve partial or complete response to chemotherapy; however, response is usually short-lived. Thoracic radiation concurrent with chemotherapy is usually recommended and can significantly improve treatment outcome. Role of surgery is limited to selected patients stage T1-T2. Twice-daily radiation to 45 Gy is currently the dose of choice. However when twice-daily radiation is not feasible, once-daily thoracic radiation at conventional fraction can be considered with 56-70 Gy being well tolerated with concurrent chemotherapy with 1-OS of 70%.

Primary complications of thoracic radiation are myelopathy, esophagitis, esophageal stricture, pneumonitis, pulmonary fibrosis, myocarditis, cardiac dysfunction, possible bone marrow toxicity, skin pigmentation, brachial plexopathy and hair loss. The benefits and complications of radiation were discussed with the patient. We also briefly talked about the role or PCI and good responders.

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