Radiotherapy for extensive stage small cell lung cancer.

Small cell lung cancer is an aggressive form of lung cancer with a poor prognosis. Most patients present with extensive stage of the disease. To reduce the high risk of brain metastases, prophylactic cranial irradiation has been shown to be very effective. Prophylactic cranial irradiation should now routinely be used for all patients who have responded to chemotherapy. Thoracic radiotherapy is often reserved for palliation. However, the high incidence of residual disease after chemotherapy and the reported beneficial effect of radiotherapy in a single study has led to two clinical trials which will soon open and address the question whether thoracic radiotherapy also has a role in responding patients with extensive stage small cell lung cancer.