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Small Cell Lung Cancer — RACP Adult Medicine MCQ

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ModerateRespiratorySmall Cell Lung CancerRACP Adult Medicine

A 70-year-old man with a 50-pack-year smoking history presents with haemoptysis and weight loss. CXR shows a central hilar mass. Bronchoscopy reveals an endobronchial lesion and biopsy shows small cell lung cancer. CT staging shows mediastinal lymphadenopathy but no distant metastases. What is the standard first-line treatment?

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Correct answer: D — Concurrent chemoradiation (cisplatin/etoposide + thoracic radiation)

Limited-stage small cell lung cancer (LS-SCLC) is treated with concurrent chemoradiation (cisplatin or carboplatin plus etoposide with twice-daily thoracic radiation). Surgery is rarely indicated. Prophylactic cranial irradiation (PCI) is considered for patients who achieve a response. The addition of durvalumab or atezolizumab to chemotherapy is standard for extensive-stage SCLC.

Reference: Cancer Council Australia – 2021 – Optimal Care Pathway for Lung Cancer