A randomized clinical trial comparing concurrent and alternating thoracic irradiation for patients with limited small cell lung carcinoma

Lebeau, B.; Urban, T.; Bréchot, J.-M.; Paillotin, D.; Vincent, J.; Leclerc, P.; Meekel, Paul; L'her, P.; Lebas, François‐Xavier; Chastang, Claude

doi:10.1002/(sici)1097-0142(19991015)86:8<1480::aid-cncr14>3.3.co;2-f

Cited by 9 publications

(14 citation statements)

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“…Univariate analysis of the prognostic factors for survival rate in patients with limited-stage small-cell lung cancer. other studies (17)(18)(19). The magnitude of benefit from PCI in the present study increased the 3-year survival rate between 35 and 53% and increased the median survival time between 21.5 and 38.8 months, which was greater than that revealed in other studies (6,12,16).…”

Section: Discussioncontrasting

confidence: 61%

Prophylactic cranial irradiation in 399 patients with limited-stage small cell lung cancer

Qiu

Xiao-fang

et al. 2016

Oncology Letters

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Abstract. The benefit of prophylactic cranial irradiation (PCI) in limited-stage small-cell lung cancer (LS-SCLC) was established in a meta-analysis performed in 1999. Since then, considerable progress has been made in the diagnosis, staging and treatment of LS-SCLC, including chemotherapy and radiotherapy, which led to a longer survival time in patients. Therefore, the magnitude of the benefit of PCI should be re-evaluated. Furthermore, the optimum timing of PCI for LS-SCLC treatment has not been established and more data is required to demonstrate this. In the present retrospective study, the cases of patients that were diagnosed with LS-SCLC between March 2005 and December 2010 were reviewed. The main eligibility criteria of patients were a diagnosis of LS-SCLC and the achievement of a complete response (CR) or near CR subsequent to receiving ≥3 cycles of cisplatin-based chemotherapy, with or without advanced thoracic radiotherapy. Early and late PCI groups were separated using the median time interval between the start of primary chemotherapy and the start of PCI. In total, 80 patients were excluded from the analysis, including 9 patients that developed brain metastases, 2 during primary chemotherapy and 7 during radiotherapy. The remaining 399 patients were deemed eligible. PCI was administered to 185 patients; 92 patients were in the early PCI group and 93 were in the late PCI group. PCI significantly decreased the incidence of brain metastases [P<0.001; HR, 0.24; 95% confidence interval (CI), 0.15-0.39] and improved the overall survival time of the patients (median survival time, 21.5-38.8 months; P<0.001; HR, 0.60; 95% CI, 0.45-0.79). However, no significant difference was identified between the early and late PCI groups, either in the incidence of brain metastases (P= 0.875) or the overall survival time (P= 0.361). Multivariate analysis revealed that PCI (P=0.004) and thoracic radiotherapy (P= 0.023) were the only 2 independent favorable prognostic factors of overall survival time. The present study demonstrates that PCI may be of considerable benefit to increase the survival rate and time of patients, and early PCI is as effective as late PCI. However, the present study recommends that PCI should be offered as soon as primary chemotherapy is completed, since there is a greater risk of developing brain metastases during thoracic radiotherapy.

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Section: Discussioncontrasting

confidence: 61%

Prophylactic cranial irradiation in 399 patients with limited-stage small cell lung cancer

Qiu

Xiao-fang

et al. 2016

Oncology Letters

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“…As a powerful strategy against nonoperative lung cancer, radical radiotherapy with concurrent chemotherapy has been earnestly tried [19], resulting in an increase in the incidence of RP and mortality due to RP [19,20]. In this study, the incidence of RP was higher in patients who underwent chemotherapy prior to radiotherapy (6 out of 9, 67%) than in those who did not (6 out of 16, 38%).…”

Section: Discussionmentioning

confidence: 62%

Diagnostic significance of surfactant proteins A and D in sera from patients with radiation pneumonitis

Takahashi¹,

Imai²,

Fujishima³

et al. 2001

Eur Respir J

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Radiation pneumonitis (RP) is the most common complication of radiotherapy for thoracic tumours. The aim of this study was to evaluate the significance of pulmonary surfactant proteins (SP)-A and SP-D as new serum markers for RP.Twenty-five patients with lung tumour, who had received radiotherapy, were studied. At the completion of radiotherapy, the presence of RP was judged by chest plain radiography and chest high resolution computed tomography (HRCT).RP findings detected on chest plain radiography were seen in only three of 12 patients in whom RP was detected by HRCT. Nevertheless, both SP-A and SP-D concentrations in sera from the patients with RP were significantly higher than those from the 13 patients without RP (p~0.0065, p~0.0011, respectively). As with SP-A, ratios of SP-D at the completion, compared to at the initiation (1 week post/pre ratio), were also significantly higher in patients with RP than in patients without RP. When a post/pre ratiow1.6 was considered positive, the SP-A and SP-D assays showed an 83% and 85% specificity, respectively.In conclusion, serum assays of surfactant proteins A and D may be of diagnostic value for detection of radiation pneumonitis, even when the radiographic change is faint.

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“…Alternating radio-chemotherapy did not influence the effectiveness of the combined treatment. Haematotoxicity was enhanced in the alternating arm of the EORTC trial [11] while the incidence of lung fibroses was lower in the alternating arm of the French trial [12] in comparison with the continuouscourse radiotherapy arms.…”

Section: Resultsmentioning

confidence: 95%

“…In the NCI Canada trial [9], a decreased incidence of brain metastases was observed in the early radiotherapy arm. Figure 3 shows the randomised trials which compare alternating radiotherapy chemotherapy arms with continuous-course radiotherapy, given either sequentially [11] or concurrently [12] with chemotherapy. In the alternating arms, radiotherapy was given in the intervals between chemotherapy cycles as a split-course therapy to minimize toxicity.…”

Section: Resultsmentioning

confidence: 99%

Localized small-cell lung cancer: which type of thoracic radiotherapy and which time schedule

Stuschke

Pöttgen

2004

Lung Cancer

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A randomized clinical trial comparing concurrent and alternating thoracic irradiation for patients with limited small cell lung carcinoma

Cited by 9 publications

References 0 publications

Prophylactic cranial irradiation in 399 patients with limited-stage small cell lung cancer

Prophylactic cranial irradiation in 399 patients with limited-stage small cell lung cancer

Diagnostic significance of surfactant proteins A and D in sera from patients with radiation pneumonitis

Localized small-cell lung cancer: which type of thoracic radiotherapy and which time schedule

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