Smallcell lung cancer and oesophageal cancer

Chemo-irradiation of intra-thoracic tumours is hindered by risk of serious morbidity, in particular pneumonitis and oesophagitis. Nonetheless, small cell-lung cancer is an excellent target for this approach; although chemosensitive local failure is inevitable with chemotherapy alone, and even with conventional consolidation radiotherapy, 40-50% of these patients have locally recurrent disease. The results of combination etoposide, cisplatin, and thoracic irradiation are promising. Toxicity, especially oesophagitis, is considerable.

Chemo-irradiation is superior to radiation therapy alone for oesophageal cancer but local failure rates remain high. Surgery after combined treatment may be the answer to this problem, but the potential for morbidity is increased further.

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