Multimodality treatment in limited small cell lung cancer (L-SCLC): different perspectives about the optimal approach

Small cell lung cancer (SCLC) is characterized by an aggressive behaviour, but limited-stage disease could be treated with curative intent. In order to improve prognosis in terms of local control and survival in this setting, several studies evaluated the benefit of a multimodality strategy including surgery, chemotherapy and radiotherapy. Recently Yang et al. confirmed the benefit of adjuvant chemotherapy alone or with cranial irradiation in a population-based cohort of patients with early-stage SCLC who underwent complete surgical resection. Results of this study are consistent with previous retrospective analysis or small prospective trials without adding anything to the current knowledge and clinical practice. In this perspective, we discuss the role and evidence supporting different locoregional approaches, in a two-hand debate, underlining the importance of a prospective randomized trial defining the best treatment strategy in limited SCLC.