Can chemotherapy be used instead of radiation therapy in a patient with extensive stage small cell lung cancer who presents with epidural spinal cord compression?

I think it would have to be done on a case-by-case basis, and the answer is likely "Not a good idea."

Chemo can make SCLC shrink a lot, but you'd really have to monitor day by day with CAT scans.

And it unlikely to take the pressure off the spinal cord arteries within hours to days, as is needed.

Th...