Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
14 Cards in this Set
- Front
- Back
|
Standard chemotherapy for small cell |
Cisplatin and etoposide |
|
|
Alternative chemotherapies that have been tried in small cell |
- Cisplatin and irinotecan |
|
|
What is the benefit of PCI in small cell patients who have a complete response to chemoRT? |
5.4% improvement in overall survival - 3 yr OS: 20.7% with PCI vs. 15.3% without |
|
|
What's the role of PCI in extensive stage small cell? |
Consider it in patients with ANY response to chemo - EORTC 08993-22993 showed 1 month improvement in median OS |
|
|
What is the optimal dose regimen for PCI? |
25 GY in 10 fx |
|
|
What is the evidence for a PCI dose of 25 Gy? |
- Tested 25/10 vs 36 Gy/18 fx vs. 36 Gy/24 fx BID - No difference in incidence of brain mets - Trend twds lower OS with higher dose (not quite ss) - More morbidity with higher dose |
|
|
What percentage of SCLC patients present with extensive stage disease? |
2/3 |
|
|
Most common sites of metastatic disease in SCLC |
Brain Liver Bone Adrenal gland |
|
|
First line chemo for extensive stage SCLC |
Cisplatin and etoposide for at least 4 cycles |
|
|
Second line chemo for extensive stage SCLC |
Something with topotecan (often) |
|
|
Is there any benefit to irradiating patients with extensive stage SCLC? |
Yes, in carefully selected patients, RT may even confer an OS benefit. |
|
|
General treatment regimen for limited stage SCLC |
Concurrent chemoRT:
If any favorable response --> PCI (25 Gy/10 fx)
|
|
|
General treatment regimen for extensive stage SCLC |
1. Chemotherapy alone with at least 4 cycles cisplatin and etoposide 2. If CR at distant sites and at least a PR in chest --> thoracic RT 3. Any favorable response --> PCI (25 Gy/10 fx) |
|
|
Which trial established the BID treatment regimen for SCOC? |
Turrisi (Intergroup 0096) |
