Patient: chest tightness found in 07-Nov for about a month, all indicators were normal after the chemotherapy and radiotherapy. The chemotherapy was completed in mid-March. After an interval of more than 20 days, the primary foci were treated with radiotherapy for one month in mid-April, and everything was normal at the end of treatment. Blood NSE:18.63 What should I do now? What kind of medicine should be used? Zhao Jun, Department of Thoracic Oncology, Beijing Cancer Hospital: If it is clear that it is extensive stage small cell lung cancer, chemotherapy should be completed at least six cycles, and at present, if the lymph node recurrence is more than three months after stopping the drug, you can consider using cisplatin + Ally chemotherapy. Patient: Is it okay if I use cisplatin plus VP16? Do I need to add other immune agents? Are there any advanced treatment options? I’ve been on the above medication since 16! My dad is in good overall health, 54 years old! Thank you! My dad and I are both doctors too!!! Can we get in touch by phone? My dad has been a surgeon for 30 years and we are worried about him! Thank you so much! Zhao Jun, Department of Thoracic Oncology, Beijing Cancer Hospital: Cisplatin plus VP16 is also fine without any other immunotherapy, which is the standard protocol for small cell lung cancer. After the lymph nodes shrink, if there are still no other sites of metastasis, you can add lymph node radiotherapy. Patient: Our oncology hospital recommends systemic radiotherapy. If the lesion disappears after chemotherapy, do I need radiotherapy too? How many courses of chemotherapy is appropriate? Thank you!!! What is the dosage of your chemotherapy drugs? My family is in Harbin, and the dosage here seems to be much less! My father is not in the hospital, he is having chemotherapy in his own unit. The current drug can be used? If not, you can change the medication! Zhao Jun, Department of Thoracic Oncology, Beijing Cancer Hospital: Radiotherapy can be used for patients in good remission to reduce local recurrence. Current chemotherapy cisplatin 80mg/m2 divided into two days and VP-16 100mg /day, day one to day five. Repeat every twenty-one days for one cycle and review after two cycles. Maximum 4-6 cycles of chemotherapy. Patient: Can you give a protocol for using Ally? Is there any medicine to prevent brain metastasis? I want to use Alfa next cycle! Is it possible? Zhao Jun, Department of Thoracic Oncology, Beijing Cancer Hospital: Alli 60 mg/m(2) days 1 and 8, cisplatin 60 mg/m(2) day 1 repeated every 21 days. In fact, if vp-16+cisplatin is effective, it is not recommended to change the regimen, and Ally can be used in case of relapse. If in complete remission after chemotherapy, brain prophylactic irradiation can be received. Patient: A course of treatment is over and the white blood cells have not been checked in time and dropped to 700, but now they have risen to 3,000 with leukostatic drugs. After the first cycle now the lymph nodes are small and nearly gone! The postponement of these days is okay! I should start the second cycle on the 6th, and there is a drug called piribicin is necessary to use? The last treatment was used! The first time I saw this, I was able to get to the hospital. The patient is still very sensitive to chemotherapy from the effect, continue chemotherapy, but this program plus the use of pirobicin may be more toxic, which may be the root cause of the significant decline in white blood cells, it is not recommended to use this drug to form a three-drug combination program, too toxic, not to increase the efficacy. It does not increase the efficacy. Cisplatin can be used over five days. The actual lymph nodes are not disappeared, and now the white blood cells are low, so people don’t dare to give chemotherapy, they say they will do PET-CT first, and radiotherapy is the main treatment, and they are afraid that the bone marrow transplant will be serious again. What should I do? The patient’s blood count was reduced to 4300 on August 15, from 16000 to 4300. Is it okay to do a bone scan, lymph node examination, head MRI, chest enhancement CT, etc. if all the tests are done alone ？？？？ Because PET/CT is too expensive! My mother is a CT doctor, so these can be done without cost! And now no one dares to give my father chemotherapy, let radiation therapy! I’m not sure what to do, but my blood count was 3700 on the 16th. What should I do? The white blood cells will only increase transiently after the use of whitening treatment, and eventually recover to about 4000, so the 3700 should be evaluated comprehensively, and it is recommended that you check again, if the white blood cells do not continue to fall, chemotherapy should be possible, if they still fall, it is recommended to perform bone marrow examination to understand the hematopoietic function. pet is just a test, false positive rate is also very high, can not completely replace the conventional examination, you can check one by one.