Aggressive Palliation in Extensive Stage Small Cell Lung Cancer, Practice Guidelines versus Clinical Practice A Case Report and Review of the Literature.pdfVIP

SAGE-Hindawi Access to Research Lung Cancer International Volume 2011, Article ID 659807, 4 pages doi:10.4061/2011/659807 Case Report Aggressive Palliation in Extensive Stage Small Cell Lung Cancer, Practice Guidelines versus Clinical Practice: A Case Report and Review of the Literature Edward F. Miles,1 Laura L. Jacimore,2 and John W. Nelson1 1 Division of Radiation Oncology, Department of Radiology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA 2 Division of Radiation Oncology, Nash General Hospital, 2460 Curtis Ellis Drive, Rocky Mount, NC 27804, USA Correspondence should be addressed to Edward F. Miles, es@ Received 21 January 2011; Accepted 18 March 2011 Academic Editor: Elisabeth Quoix Copyright © 2011 Edward F. Miles et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Small cell lung cancer (SCLC) constitutes approximately 16% of all primary lung cancers, with more than 35,000 new cases per year. Two-thirds of patients present with extensive stage disease (ES-SCLC) due to a tendency to metastasize early. Outcomes remain poor, with a median survival of approximately 10 months and a two-year overall survival of 10%. Current recommendations call for combination chemotherapy alone in patients without localized symptoms. Thoracic radiation therapy following a good clinical response is controversial. We report on a patient with ES-SCLC that had an excellent response to chemotherapy and underwent whole brain radiotherapy for a known brain metastasis and consolidative radiotherapy to the thorax. His latest follow- up demonstrates only a