How would you approach treatment for patients with limited stage small cell lung cancer who, after initial carboplatin/etoposide, develop a new contralateral lung nodule confirmed as SCLC, while their primary tumor shows a partial response?  

I assume the scenario is a newly diagnosed LS SCLC in a patient who was appropriately staged with PETCT, brain MRI, etc at time of initial diagnosis. Patient is then treated with definitive chemorads with 4 cycles of platinum/etoposide and xrt. At the time of re staging PETCT, a new contralateral no...