A 68-year-old man with a 60-pack-year smoking history is evaluated because of hemoptysis. Radiograph of the chest shows a right hilar mass and mediastinal widening. CT scans of the chest and abdomen confirm the hilar mass and bulky lymphadenopathy in the mediastinum with no other overt metastases. Bronchoscopic biopsy specimen shows small-cell lung cancer. Bone scan and CT scan of the head are negative for tumor. A low serum sodium level and inappropriately high urine osmolality suggest that he has the syndrome of inappropriate antidiuretic hormone secretion. Which of the following is the most appropriate treatment recommendation?

Question

Quizplus · Accepted Answer

Small-cell lung cancer (SCLC) is typically treated with a combination of chemotherapy and radiation therapy, especially in limited-stage disease where the cancer is confined to one lung and its nearby lymph nodes. The scenario describes a case of SCLC with mediastinal involvement but no distant metastases, suggesting limited-stage disease. Concurrent chemoradiation is the standard of care for such cases, aiming to maximize local control and improve survival.

A 68-Year-Old Man with a 60-Pack-Year Smoking History Is Evaluated