Radiothérapie des cancers bronchiques à petites cellules

Small cell lung cancer (SCLC) accounts for about 13% of lung cancers. With a decreasing incidence in the last twenty years, SCLC remains a cancer with a particularly bleak prognosis due in particular to a short doubling time which explains the metastatic presentation in nearly two thirds of the cases at diagnosis. Although chemotherapy remains the cornerstone of SCLC treatment, since the 1980s radiotherapy has taken a growing place in multidisciplinary care. The treatment of localized forms (stages I to III) is based on the combination of radiochemotherapy. While the concomitant association of radiotherapy and chemotherapy is now gaining consensus, questions remain about the optimal dose, fractionation and systemic treatment to be combined with radiotherapy. Treatment of metastatic forms is essentially based on multidrug therapy based on platinum and Etoposide. The benefit of local treatment of intrathoracic disease in the metastatic stage by thoracic consolidation irradiation is promising but requires confirmatory studies. Prophylactic cerebral irradiation (IPC) remains a standard of care in localized forms in good responders but its place is more controversial in the metastatic setting.