Journal of Clinical Oncology, Vol 2, 1359-1365, Copyright © 1984 by American Society of Clinical Oncology
The role of computed tomography of the chest in the management of small- cell lung cancer
CA Griffin, C Lu, EK Fishman, N Khouri, M Markman, SS Siegelman and MD Abeloff
Despite the wide application of computed tomography (CT) in the diagnosis
and management of lung cancer, the role of this diagnostic modality in the
management of small-cell lung cancer (SCC) has not yet been defined. We
therefore compared information gained from routine chest radiography (CXR)
and CT scans performed on 32 patients with SCC who were treated on an
intensive chemotherapy-radiotherapy protocol. Seventy-nine pairs of CXRs
and CT scans were retrospectively reviewed. We found that although CT
delineates a greater extent of intrathoracic disease in each of nine
anatomic areas evaluated than does CXR, agreement between CT and CXR was
significant for all areas except the pericardium. Pericardial thickening
was seen only on CT scan and is more frequent in SCC patients than has
previously been appreciated, but both its etiology and prognostic
significance are unclear at this time. CT also allowed interpretation of
disease status in cases where radiation-induced fibrosis made
interpretation of the CXR impossible. We do not recommend routine use of
chest CT at time of diagnosis of SCC, but we recommend that its use be
reserved for evaluation of new symptoms or suspected relapse, or when
radiation fibrosis on CXR is severe.
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