Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review
Paraneoplastic Cushing’s syndrome (PCS) is a rare, but clinically important feature of small cell lung cancer (SCLC) that is associated with even worse prognosis. To identify key considerations in comprehensive management of SCLC patients complicated with PCS, we conducted a systematic review of rel...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1177125/full |
| _version_ | 1797658207721619456 |
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| author | Yanlong Li Caiyu Li Xiangjun Qi Ling Yu Lizhu Lin |
| author_facet | Yanlong Li Caiyu Li Xiangjun Qi Ling Yu Lizhu Lin |
| author_sort | Yanlong Li |
| collection | DOAJ |
| description | Paraneoplastic Cushing’s syndrome (PCS) is a rare, but clinically important feature of small cell lung cancer (SCLC) that is associated with even worse prognosis. To identify key considerations in comprehensive management of SCLC patients complicated with PCS, we conducted a systematic review of relevant reports on PubMed and Web of Science, focusing on SCLC with PCS cases. The systematic review analyzed 61 reports published between 1985 and 2022 with a total of 157 SCLC patients included. Out of the 157 patients, 132 (84.1%) patients across 58 (95.1%) reports were diagnosed with ectopic Cushing’s syndrome. The immunohistochemical (IHC) staining for adrenocorticotropic hormone (ACTH) was performed on 30 (19.1%) patients across 22 (36.1%) reports and demonstrated encouraging performance. For treatment, chemotherapy and ketoconazole were utilized in 50 (81.97%) and 24 (39.34%) reports, respectively. Regarding cause of death, infection and cancer were equally frequent, each being recorded in 17 (27.87%) reports. To conclude, the majority of PCS cases in SCLC patients were caused by ectopic hormone secretion. In order to make a differential diagnosis, it is recommended to utilize IHC staining for a specific hormone such as ACTH or corticotropin-releasing hormone. In the comprehensive treatment of SCLC with PCS patients, effective management of hypercortisolism and potent safeguarding against infection play two crucial roles. Ultimately, further confirmations are required regarding the specificity and accuracy of IHC staining technique as well as the efficacy and safety of immunotherapy in the treatment of SCLC with PCS patients. |
| first_indexed | 2024-03-11T17:55:52Z |
| format | Article |
| id | doaj.art-2fd4d22caeb04d38b983990b521446a4 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T17:55:52Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-2fd4d22caeb04d38b983990b521446a42023-10-17T12:57:34ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-10-011410.3389/fendo.2023.11771251177125Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature reviewYanlong Li0Caiyu Li1Xiangjun Qi2Ling Yu3Lizhu Lin4The First Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaThe First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, ChinaParaneoplastic Cushing’s syndrome (PCS) is a rare, but clinically important feature of small cell lung cancer (SCLC) that is associated with even worse prognosis. To identify key considerations in comprehensive management of SCLC patients complicated with PCS, we conducted a systematic review of relevant reports on PubMed and Web of Science, focusing on SCLC with PCS cases. The systematic review analyzed 61 reports published between 1985 and 2022 with a total of 157 SCLC patients included. Out of the 157 patients, 132 (84.1%) patients across 58 (95.1%) reports were diagnosed with ectopic Cushing’s syndrome. The immunohistochemical (IHC) staining for adrenocorticotropic hormone (ACTH) was performed on 30 (19.1%) patients across 22 (36.1%) reports and demonstrated encouraging performance. For treatment, chemotherapy and ketoconazole were utilized in 50 (81.97%) and 24 (39.34%) reports, respectively. Regarding cause of death, infection and cancer were equally frequent, each being recorded in 17 (27.87%) reports. To conclude, the majority of PCS cases in SCLC patients were caused by ectopic hormone secretion. In order to make a differential diagnosis, it is recommended to utilize IHC staining for a specific hormone such as ACTH or corticotropin-releasing hormone. In the comprehensive treatment of SCLC with PCS patients, effective management of hypercortisolism and potent safeguarding against infection play two crucial roles. Ultimately, further confirmations are required regarding the specificity and accuracy of IHC staining technique as well as the efficacy and safety of immunotherapy in the treatment of SCLC with PCS patients.https://www.frontiersin.org/articles/10.3389/fendo.2023.1177125/fullsmall cell lung cancerparaneoplastic Cushing’s syndromeneuroendocrine tumormanagementimmunohistochemistryinfection |
| spellingShingle | Yanlong Li Caiyu Li Xiangjun Qi Ling Yu Lizhu Lin Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review Frontiers in Endocrinology small cell lung cancer paraneoplastic Cushing’s syndrome neuroendocrine tumor management immunohistochemistry infection |
| title | Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review |
| title_full | Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review |
| title_fullStr | Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review |
| title_full_unstemmed | Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review |
| title_short | Management of small cell lung cancer complicated with paraneoplastic Cushing’s syndrome: a systematic literature review |
| title_sort | management of small cell lung cancer complicated with paraneoplastic cushing s syndrome a systematic literature review |
| topic | small cell lung cancer paraneoplastic Cushing’s syndrome neuroendocrine tumor management immunohistochemistry infection |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1177125/full |
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