How would you manage a treatment-naive patient who has painful vertebral lesions from ES-SCLC?

For patients with painful SCLC vertebral metastases and no evidence of cord compression, would you recommend treating with immediate systemic therapy or delaying systemic therapy for palliative RT?

Answer from: Radiation Oncologist at Community Practice

ES-SCLC is incurable. If they are in pain, treat their pain. Chemotherapy is palliative. TRT may extend life, but the average life expectancy with ES-SCLC is limited. Don't let patients in pain suffer when we have an effective way to treat them. I would consider very short courses - 1...

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