Treatment and prognosis
of extensive-stage small cell lung cancer
1. Introduction Small Cell Lung Cancer (SCLC) is a type of lung cancer, which is highly invasive and rapidly growing. Extensive-stage Stage Small Cell Lung Cancer (ES-SCLC) is defined as a cancer that has spread beyond one side of the thorax to the contralateral lung, mediastinum, lymph nodes around the heart, and even more distant organs such as liver, brain and so on. The treatment of this cancer is relatively difficult and the prognosis is poor, but through scientific and reasonable treatment, patients may still get a certain survival time and quality of life improvement. 2. The main methods of chemotherapy for extensive small cell lung cancer: Chemotherapy is the main treatment for extensive small cell lung cancer. Anti-cancer chemicals can be injected intravenously to effectively kill cancer cells or inhibit their growth. Commonly used regimens: First-line chemotherapy regimens usually include etoposide plus cisplatin (EP regimen) or etoposide plus carboplatin (EC regimen). In addition, irinotecan plus cisplatin (IP regimen) or irinotecan plus carboplatin (IC regimen) are also options. Efficacy: Chemotherapy is highly effective in extensive small cell lung cancer, with an effective rate of 70% and a control rate of 90%, but the control time is relatively short, usually 5-6 months. Effect of radiotherapy: For some patients whose condition is under control after chemotherapy, chest radiotherapy can be considered to further kill cancer cells. In addition, prophylactic whole-brain irradiation (PCI) is also recommended to reduce the risk of brain metastases. Side effects: Radiotherapy can bring certain side effects, such as radiation injury, immunosuppression, radiation pneumonia, etc. Patients need to weigh the pros and cons under the guidance of a doctor. Immunotherapy: In recent years, immunotherapy has gradually emerged in the treatment of small cell lung cancer. Immune checkpoint inhibitors, such as PD-1 inhibitors and PD-L1 inhibitors, enhance the ability to kill cancer cells by cooperating with the body’s immune system. Efficacy: Although the efficacy of immunotherapy in extensive stage small cell lung cancer needs further validation, studies have shown that it can prolong the survival of patients and improve the prognosis. New drugs for targeted therapy: Although the traditional response of extensive stage small cell lung cancer to targeted therapy is poor, in recent years, with the deepening of research, some new targeted drugs such as Anlotinib have begun to be used in the treatment of extensive stage small cell lung cancer, and have achieved certain efficacy. Combination therapy: Due to the complexity of extensive stage small cell lung cancer, monotherapy is often difficult to achieve the desired effect. Therefore, combination therapy has become an important means to improve the therapeutic effect. Chemotherapy combined with immunotherapy and chemotherapy combined with targeted therapy are being studied and explored. 3. Prognosis and survival time of extensive small cell lung cancer The prognosis of patients with extensive small cell lung cancer is poor, and the median survival time after diagnosis is about 9-10 months. However, with the emergence of new treatment options and drugs, the efficacy is getting better and better, and the long-term survival effect has been improved. The prognosis is affected by many factors, including the patient’s age, physical condition, pathological type, clinical stage, treatment and so on. Early detection, early treatment and effective comprehensive treatment are the key to improve the therapeutic effect. In addition to medical treatment, psychological care and family support are also crucial. Patients and their families should maintain an optimistic attitude, face the disease positively, and provide continuous care and comfort for patients. 4. Conclusion The treatment of extensive stage small cell lung cancer is a complex and arduous process, which requires the joint efforts of patients, their families and healthcare workers. Through scientific and reasonable treatment and comprehensive nursing support, patients can prolong their survival time and improve their quality of life to a certain extent. With the deepening of medical research and the continuous innovation of technology, more new drugs and therapies will come out in the future, bringing more hope and possibility to patients. Let us work together to defeat this disease.
