BACKGROUND: Small cell lung cancer (SCLC) results in death within 1-2 months if left untreated. Although therapeutic standards only comprise first- and second-line chemotherapy due to poor prognosis, a subset of patients may warrant a trial of further chemotherapy, as demonstrated in the following case. CASE REPORT: We present a 52-year-old man with confirmed anaplastic SCLC who survived 10 years while receiving 9 lines of chemotherapy including high-dose chemotherapy. Thoracic radiation, afterloading and radionuclide therapy supplemented the therapeutic management. Remarkably, he had two very long remission periods following topotecan. CONCLUSION: This case indicates that frequently repeated chemotherapy beyond second-line treatment in a subset of patients with limited-disease SCLC may result in long-term survival, even without ever achieving a complete remission. Close surveillance of responsiveness and appropriate in-time cytostatic treatment is proposed in the management of patients with SCLC who remain in good performance. Copyright 2008 S. Karger AG, Basel.
BACKGROUND:Small cell lung cancer (SCLC) results in death within 1-2 months if left untreated. Although therapeutic standards only comprise first- and second-line chemotherapy due to poor prognosis, a subset of patients may warrant a trial of further chemotherapy, as demonstrated in the following case. CASE REPORT: We present a 52-year-old man with confirmed anaplastic SCLC who survived 10 years while receiving 9 lines of chemotherapy including high-dose chemotherapy. Thoracic radiation, afterloading and radionuclide therapy supplemented the therapeutic management. Remarkably, he had two very long remission periods following topotecan. CONCLUSION: This case indicates that frequently repeated chemotherapy beyond second-line treatment in a subset of patients with limited-disease SCLC may result in long-term survival, even without ever achieving a complete remission. Close surveillance of responsiveness and appropriate in-time cytostatic treatment is proposed in the management of patients with SCLC who remain in good performance. Copyright 2008 S. Karger AG, Basel.