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Is my father on the correct treatment for small cell carcinoma?

Q: My 70 years old father is suffering from small cell carcinoma with superior vena cava (SVC) syndrome and the doctor said that he has limited stage cancer. My father had massive swelling in and around his face and has undergone 6 cycles of chemotherapy with Etoposide and Cisplatin. His swelling went away but it came back and then he underwent palliative radiation for 10 days. This radiation was done 45 days back and now his swelling has almost gone away and he is on Xefta (Gefitinib), though he has not taken it for the last 20 days. Is Xefta effective for small cell carcinoma? As I surmise it is used for non-small cell types. Please illuminate. How long is he going to survive?

A:You are absolutely right that Gefitinib is used for Non Small Cell Lung Cancer. I do not know what made your treating oncologist prescribe the drug for your father, but there is only one case report in the literature about the use of Gefitinib in Small Cell Lung Cancer. I am providing you with the link to view this article below:

I think since your father had a limited stage SCLC with SVC obstruction and responded well to the first line chemotherapy, he should have been evaluated for a response after completion of chemotherapy. If he had a complete response he should have been subjected to a radical radiotherapy to the chest and a prophylactic cranial irradiation at that point in time. We should not have waited for his disease to come back and then resort to palliative radiation.

It is difficult to comment upon the survival of the patient without evaluating his current disease status.


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