Lung cancer recurrent disease

Small cell lung cancer typically presents as extensive disease (approximately 60% to 70% of new cases) and progresses very quickly. Small cell carcinomas are very responsive to chemotherapy and radiation. Radiotherapy became the standard in 1969, when a randomized trial showed that it offered the potential for cure, whereas surgery did not.20 For the vast majority of patients, chemotherapy with or without radiotherapy is the treatment of choice. Even after a complete response to therapy, the cancer usually recurs within 6 to 8 months, and survival time following recurrence is typically short ( 4 months). This yields a typical survival rate of 14 to 20 months for limited disease and 8 to 13 months for extensive disease.33 Table 87-6 illustrates the general treatment path of SCLC. 

Fig. 9.2. These images are from a 70-year-old male with recurrent small-cell lung cancer evaluated for CyberKnife treatment of an isolated right adrenal lesion. PET/CT showed previously unsuspected mediastinal, left adrenal, and retroperitoneal disease...

Onishi et al. 2004 Non-small cell lung cancer stage I Hypofractionated stereotactic radiotherapy Crude rate of local-disease recurrence 13.5% 5-Year cause-specific survival 78%... 

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