Treatment of Medically Inoperable Limited-Stage Small Cell Lung Cancer (Clinical Stage I–IIA, T1–2, N0, M0)

This protocol applies to patients with small cell lung cancer (SCLC) at limited stage — specifically clinical stage I–IIA (T1–2, N0, M0) — who are medically inoperable or for whom a decision has been made not to pursue surgical resection.

Selected patients in this setting may be candidates for stereotactic ablative radiotherapy (SABR/SBRT) directed at the primary tumour, followed by adjuvant systemic therapy. Management integrates locoregional control with subsequent systemic treatment.

For patients with performance status 0–2, subsequent systemic therapy encompasses a defined set of preferred and additionally recommended options spanning multiple drug classes. Which agents are appropriate depends on prior treatment history and individual patient factors — the full protocol specifies the complete selection criteria, sequencing guidance, and continuation rules.

The treatment goal is disease response — complete or partial — evaluated by CT imaging after every 2–3 cycles of systemic therapy.