Clinical Benefit of Chemotherapy for Small-Cell Lung Cancer Patients with Extremely Poor Performance Status (PS)

Abstract

Purpose: We investigated whether small-cell lung cancer (SCLC) patients with The Eastern Cooperative Oncology Group Performance Status (PS) 4 could benefit from chemotherapy. Methods: PS 4 patients were extracted from medical records, and their characteristics including administered drugs and relevant dosages were obtained. Response, toxicities, survival and changes in PS were retrospectively evaluated. Results: Of the 314 patients, 25 patients exhibited PS 4. Excepted for 4 patients without chemotherapy, 21 patients were treated with reduced doses in the first cycle, and, with recovery of PS (42.9% improved PS), the doses were increased in subsequent cycles (median of 3 cycles). Response rate was 66.7%, and progression free survival of patients with chemotherapy was 94 days (95% confidence interval [CI], 81 to 107 days). Median survival time was 195 days (95% CI, 81 to 269 days). While, the range of survival times for 4 patients without chemotherapy was 10 to 32 days. Grade 4 neutropenia occurred in 10 patients, and one patient experienced treatment-related death. A significant difference in survival was observed between improved and non-improved PS groups (263 and 83.5 days, respectively; p = 0.029). Conclusion: There could be a chance for chemotherapy in SCLC patients with PS 4.