Efficacy of 3D conformal thoracic radiotherapy for extensive-stage small-cell lung cancer: A retrospective study

Luan, Zupeng; Wang, Zhiwu; Zhang, Jian; Dong, Wei; Zhang, Wei; Li, Baosheng; Zhou, Tao; Li, Hongsheng; Zhang, Zicheng; Wang, Zhongtang; Sun, Hongfu; Yi, Yan

doi:10.3892/etm.2015.2526

Cited by 18 publications

(21 citation statements)

References 34 publications

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“…In our patients, about 24% were presented by single site of metastasis while 11% had ≥2 sites and bone was the most common site of metastasis followed by brain similar to what reported by Luan et al [28]. However, others found that the frequency of metastatic sites were liver then brain and bone [29] [30].…”

Section: Discussionsupporting

confidence: 87%

“…As regard prognostic factors for survival; ECOG of 0 -1 was associated with significantly higher survival (P = 0.04) comparable to that recorded by Nathan R et al [35] who explained that by receiving more often full dose therapy in patients with ECOG 0 -1 than those with ECOG ≥ 2. 2-year survival rate 35% with median overall survival time of 14 months comparable to what reported by Luan Z et al [28] and Unalmis et al [29]. While Ramlov A et al [50] recorded higher median survival time which can be attributed to higher percentage of patients with LD-SCLC in their study (62.7%).…”

Section: Discussionsupporting

confidence: 76%

“…In our study, leucopenia was the most prevalent hematologic toxicity (41.3%) while esophagitis (23.8%) followed by pneumonitis (15.9%) were the most frequent non hematologic one. But Luanz reported incidence of pneumonitis and esophagitis of 1.8% and 1.2% respectively [28]. This can be explained by using 3D conformal TRT for all his patients while only 7.6% of our group treated by 3D conformal TRT.…”

Section: Discussionmentioning

confidence: 65%

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Outcomes and Prognostic Factors of Small Cell Lung Cancer: A Retrospective Study

Wahba¹,

El-Hadaad²,

Anter³

et al. 2018

ALC

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Background: Small cell lung cancer (SCLC) is a high grade neuroendocrine tumor, and has aggressive nature, so the majority of cases are presented with extensive disease. SCLC was staged into 2 categories: limited-stage disease (LS-SCLC) and extensive disease (ES-SCLC). Despite SCLC is sensitive to radiotherapy and chemotherapy, SCLC has high tendency for rapid dissemination to regional and distant sites. Median survival time ranged from 2-4 months in patients with untreated SCLC. Multiagent chemotherapy was the primary treatment for SCLC. Aim of the work: This retrospective study was conducted to evaluate and analyze clinical features, treatment outcome, survival and prognostic factors affecting survival in patients with SCLC presented to Clinical Oncology and Nuclear Medicine department, Chest department and Medical oncology unit in Mansoura Oncology Centre during the period from 2000-2015. Methods: Data of patients were collected from their files. The information obtained included demographic features, treatment received; its toxicity and outcome, survival and its prognostic factors. Demographic data were: age, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), smoking status, stage of disease. Data also included disease presentation and metastatic sites. Several factors affecting survival were analysed as age, sex, stage, PS, smoking status and LDH. Results: Sixty-three patients were enrolled in this study. Median age was 56.2 ± 6. Strong male predominance (92.1%) was observed; 84.1% of them were smoker. Thirty six patients (57.2%) were of ECOG-PS of 0-1. ES-SCLC was reported in 65% of cases and LDH was high (>1.5 xN) in 47.6%. The most common symptom was chest pain (38.1%) followed by cough (31.8%), weight loss (30%). Fifteen patients had single metastatic site (23.8%

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 65%

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Outcomes and Prognostic Factors of Small Cell Lung Cancer: A Retrospective Study

Wahba¹,

El-Hadaad²,

Anter³

et al. 2018

ALC

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“…We analyzed those patients with CR and PR to systemic therapy but got discordant conclusion as the previous two studies mentioned above. Moreover, receiving TRT at 45Gy/30 fractions twice per day translated into a survival bene t in the OS and PFS in contrast with receiving radiotherapy at 60Gy/30 fractions daily, which was concurs with the ndings of previous studies by Luan Z et al [24]. Different radiation fractionations employed may lead to the opposite result.…”

Section: Discussionsupporting

confidence: 90%

Clinical Outcomes of Extensive Stage Small Cell Lung Cancer Patients Treated With Thoracic Radiotherapy at Different Timing and Fractionation

Han

2020

Preprint

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Objective: The purpose of this study was to assess whether combined thoracic radiotherapy (TRT) on the basis of chemotherapy (ChT) showed promising anti-tumor activity in extensive-stage small cell lung cancer (ES-SCLC), then to explore practice patterns for radiation time and dose/ fractionation and to identify prognostic factors for patients who would benefit from ChT/TRT.Methods: A total of 492 ES-SCLC patients were included from January 2010 to March 2019, of which 244 patients experienced ChT/TRT. Propensity score matching (PSM) was performed to minimize bias between the ChT/TRT and ChT-alone groups. Patients in ChT/TRT group were categorized into four groups based on the number of induction chemotherapy cycles. For effective dose fractionation calculation, we introduced the time-adjusted biological effective dose(tBED). Categorical variables were analyzed with Chi-square tests and Fisher’s exact tests. Survival rates were computed by the Kaplan-Meier method. Multivariate prognostic analysis was performed with Cox proportional hazard models. Results: Patients who received ChT/TRT were associated with improved OS (18.2 vs 10.8 months), PFS (9.0 vs 6.0 months) and LRFS (12.0 vs 6.0 months) before matching, with similar results after matching. In the ChT/TRT group, the median LRFS times for groups based on radiation time were 12.7, 12.0, 12.7, and 9.0 months, respectively. Earlier TRT had a tendency to prolong PFS (median 10.6 vs 9.8 vs 9.1 vs 7.7 months, respectively, p = 0.1095), as was not seen in OS (median 17.6 vs 19.5 vs 17.2 vs 19.1 months, respectively, p = 0.7224). To note, patients within 6 cycles had better LRFS (p = 0.0006). For radiation dose, patients in high-dose group (tBED>50Gy) had worse OS (median 25.9 vs 22.9, p = 0.0484) and PFS (median 12.1 vs 11.2, p=0.0042) in patients with complete response and partial response (CR and PR) to systemic therapy, but the above-mentioned results were not drawn when the population was confined to those receiving standard fractionation with CR and PR. Conclusion: ChT/TRT could improve survival for ES-SCLC patients. We cautiously recommend that TRT should be performed within 6 cycles and receiving hyperfractionated 45Gy in 30 fractions may be a feasible treatment scheme for ES-SCLC patients.

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“…This study confirmed that TRT in addition to PCI should be considered for all patients with ES-SCLC who respond to chemotherapy. Other prospective and retrospective studies reported positive results with TRT in ES-SCLC in terms of survival and RR [37–39]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy of cisplatin–etoposide and the role of thoracic radiotherapy and prophylactic cranial irradiation in LCNEC

et al. 2017

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In small-cell lung cancer (SCLC), the role of chemotherapy and radiotherapy is well established. Large-cell neuroendocrine carcinoma (LCNEC) shares several clinicopathological features with SCLC, but its optimal therapy is not defined. We evaluated clinical response and survival outcomes of advanced LCNEC treated in first-line therapy compared with SCLC.72 patients with stage III–IV LCNEC (n=28) and extensive-stage SCLC (ES-SCLC) (n=44) received cisplatin–etoposide with/without thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI).Comparing LCNEC with SCLC, we observed similar response rates (64.2% versus 59.1%), disease control rates (82.1% versus 88.6%), progression-free survival (mPFS) (7.4 versus 6.1 months) and overall survival (mOS) (10.4 versus 10.9 months). TRT and PCI in both histologies showed a benefit in mOS (34 versus 7.8 months and 34 versus 8.6 months, both p=0.0001). LCNEC patients receiving TRT showed an improvement in mPFS and mOS (12.5 versus 5 months, p=0.02 and 28.3 versus 5 months, p=0.004), similarly to ES-SCLC. PCI in LCNEC showed an increase in mPFS (20.5 versus 6.4 months, p=0.09) and mOS (33.4 versus 8.6 months, p=0.05), as in ES-SCLC.Advanced LCNEC treated with SCLC first-line therapy has a similar clinical response and survival outcomes to ES-SCLC.

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Efficacy of 3D conformal thoracic radiotherapy for extensive-stage small-cell lung cancer: A retrospective study

Cited by 18 publications

References 34 publications

Outcomes and Prognostic Factors of Small Cell Lung Cancer: A Retrospective Study

Outcomes and Prognostic Factors of Small Cell Lung Cancer: A Retrospective Study

Clinical Outcomes of Extensive Stage Small Cell Lung Cancer Patients Treated With Thoracic Radiotherapy at Different Timing and Fractionation

Evaluation of the efficacy of cisplatin–etoposide and the role of thoracic radiotherapy and prophylactic cranial irradiation in LCNEC

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