Palliative care in poor-performance status small cell lung cancer patients: is there a mandatory role for chemotherapy?

Abstract

Median survival for ECOG PS 4 patients treated with chemotherapy in our series was extremely short with a high rate of early deaths. ECOG PS 3 patients also showed a poor survival. These data suggest that we need a more comprehensive approach and further studies, regarding the palliative care of this high-risk population.

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

“…Therefore, even in the case of patients with PS 4, it was considered there was clinical benefit from first-line chemotherapy. In addition, the effects seen in our study were slightly inferior to the results of a prospective clinical trial in patients under 70 years having PS 3, which showed a MST of 6.9 to 7.1 months 10) . There is a limitation to our study.…”

“…However, a reference point to select either chemotherapy or supportive care is not clear; furthermore, there have only been a few reports citing the use of chemotherapy for SCLC patients with extremely poor PS. Indeed, there have been only two retrospective reports mentioning PS 4 patients in this context 9,10) . Sakuragi et al reported on five PS 4 patients 9) .…”

“…The median survival time (MST) in this patient cohort was 1.7 months. Baldotto et al reported on ten PS 4 patients treated with either cisplatin plus etoposide or carboplatin plus etoposide 10) , with the MST being 7 days (95% CI: 0.00-14.7). While, there was a prospective phase III trial investigating oral etoposide included…”

Epidemiological And Clinical Characteristics Of Lung Cancer Patients at the City of Rize

“…Serum LDH düzeylerinin KHAK'de yüksek olarak saptandığı ve önemli prognostik faktörler arasında olduğu bilinir 18,19 . Çalışmamızda KHAK'li hastalarda hem adenokanser hem de skuamoz hücreli kansere göre anlamlı derecede yüksek LDH düzeyi elde ettik.…”

Nonsurgical oncological management of cancer pain

“…Using metastatic soft tissue sarcoma (STS) as an example, systemic chemotherapy generally offers moderate response rates (10-40%) [74] with a significant potential for toxicity, even at reduced doses [75]. The most widely used prognostic indicator is performance status: patients with performance status 3-4 are unlikely to benefit from systemic treatments, whereas the decision can be less clear in those with a performance status of 2 [79][80][81]. There are therefore patients unlikely to gain 'palliative' benefit from starting chemotherapy who are also at risk of dying soon after treatment initiation.…”