326 Ch 325. Small Cell Lung Cancer, Neuroendocrine Tumors, and Paraneoplastic Syndromes

SCLC = 15% of lung cancer，almost exclusively smokers；central, aggressive, fast-growing，median doubling time 30 days；高比例 paraneoplastic syndromes；staging = limited (LS-SCLC, confined to one hemithorax, single radiation field) vs extensive (ES-SCLC, beyond)；LS-SCLC：concurrent chemoradiation (cisplatin + etoposide + 45 Gy BID) + PCI (prophylactic cranial irradiation)；ES-SCLC：chemotherapy + atezolizumab (IMpower133) or durvalumab (CASPIAN) + TARLATAMAB (DLL3-targeted BiTE, 2024 FDA, DeLLphi-301) — 新利器；TP53 + RB1 mutations universal；carcinoid tumors (typical, atypical) — neuroendocrine, surgical for localized；large cell neuroendocrine carcinoma (LCNEC) — between SCLC and NSCLC；paraneoplastic syndromes：SCLC (SIADH, ACTH-Cushing, LEMS, limbic encephalitis); squamous (PTHrP); adenocarcinoma (HOA + clubbing); 廣泛 (DIC, Trousseau, anemia)。