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Topics:
Radiation Oncology • Thoracic Malignancies • Medical Oncology • Small cell lung cancer • Internal Medicine • Pulmonology
How do you approach management of limited stage SCLC in a patient with idiopathic pulmonary fibrosis?
Answer from: Radiation Oncologist at Academic Institution
I've seen a few patients with IPF and small cell. The concern is always that these patients have an underlying pro-inflammatory lung condition that makes them more prone to pneumonitis. My preference in this specific group is to give and complete chemotherapy first and then restage the patient. Sinc...
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Answer from: Medical Oncologist at Community Practice
Depends on the severity of PF. This is a multidisciplinary (and patient) decision. We tend to treat with concurrent chemoradiation if IPF is mild or even moderate and stable. We have also treated some patients with mild but progressive IPF with CRT along with antiproliferative/antifibrotic agents fo...
Answer from: Radiation Oncologist at Community Practice
I’ve never seen a case with LS-SCLC and pulmonary fibrosis. Without a CT, or PFT’s, I would tend to treat with 4 cycles Carbo/Etoposide. If there were no N+ nodes to start, I would hypofx 45 Gy in 3 weeks or 60 in 4 to the residual lesion. If N2 positive, concurrent 45 Gy bid cycle 3 con...