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Limited-stage vs extensive-stage (small-cell lung cancer)

aka limited-stage, limited stage, LS-SCLC, extensive-stage, extensive stage, ES-SCLC, very limited stage, thoracic radiotherapy, consolidative thoracic radiotherapy

Small-cell lung cancer uses a two-way split instead of the usual four stages: limited (confined to one side of the chest and treatable within one radiation field, about a third of patients) or extensive (everything else).

Limited-stage disease receives concurrent platinum-etoposide and thoracic radiotherapy (45 Gy twice daily or 60-70 Gy once daily) with curative intent, now followed by durvalumab consolidation (ADRIATIC), and cures 25-35%; extensive-stage disease receives platinum-etoposide with atezolizumab or durvalumab (IMpower133, CASPIAN), responds in most patients and relapses in most within a year, with tarlatamab now the preferred second-line drug. Prophylactic cranial irradiation or MRI surveillance follows response in both. TNM staging is applied in parallel but the two-stage system still drives treatment.

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Treatment jargon

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