Phase III trial of concurrent thoracic radiotherapy with either first- or third-cycle chemotherapy for limited-disease small-cell lung cancer

Sun, Jong‐Mu; Ahn, Yong-Chan; Choi, Eun Kyung; Ahn, Myung‐Ju; Ahn, Jin Seok; Lee, S.-H.; Lee, D.H.; Pyo, Hongryull; Song, Si Yeol; Jung, Sin‐Ho; Jo, Jaemin; Jo, Jae‐Cheol; Sohn, Hee-Jung; Suh, Cheolwon; Lee, Joong Sun; Kim, S.-W.; Park, K.

doi:10.1093/annonc/mdt140

Cited by 99 publications

(75 citation statements)

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“…When platinumbased chemotherapy is used concurrently with TRT, 2-and 5-year survival rates have been shown to favour of early TRT. Also in Sun et al (2013) phase III trial 222 LS-SCLC patients were evaluated, and they showed that, TRT starting in the third cycle of chemotherapy had noninferiority to early TRT. Response rates, OS, and PFS were comparerable in both arms (Sun et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Also in Sun et al (2013) phase III trial 222 LS-SCLC patients were evaluated, and they showed that, TRT starting in the third cycle of chemotherapy had noninferiority to early TRT. Response rates, OS, and PFS were comparerable in both arms (Sun et al, 2013). Results of different studies on early vs late TRT were shown at (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…However, a trial repeating the design of an earlier trial reported no difference on survival rates between early and late TRT (Fried et al, 2004). Recently published randomized phase III trial of Sun et al (Sun et al, 2013) demonstrated that outcome achieved with TRT starting with the third cycle of CT is non-inferior to results when TRT was administered from the first day of systemic treatment. Median survival, remission rates and estimated 5-year survival rates were equal in early and late arms and comparable with best historical results.…”

Section: Introductionmentioning

confidence: 96%

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Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Bayman¹,

Etiz²,

Akçay³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: It is standard treatment to combine chemotherapy (CT) and thoracic radiotherapy (TRT) in treating patients with limited stage small cell lung cancer (LS-SCLC). However, optimal timing of TRT is unclear. We here evaluated the survival impact of early versus late TRT in patients with LS-SCLC. Materials and Methods: Follow-up was retrospectively analyzed for seventy consecutive LS-SCLC patients who had successfully completed chemo-TRT between January 2006 and January 2012. Patients received TRT after either 1 to 2 cycles of CT (early TRT) or after 3 to 6 cycles of CT (late TRT). Survival and response rates were evaluated using the Kaplan-Meier method and comparisons were made using the multivariate Cox regression test. Results: Median follow-up was 24 (5 to 57) months. Carboplatin+etoposide was the most frequent induction CT (59%). Median overall, disease free, and metastasis free survivals in all patients were 15 (5 to 57), 5 (0 to 48) and 11 (3 to 57) months respectively. Late TRT was superior to early TRT group in terms of response rate (p=0.05). 3 year overall survival (OS) rates in late versus early TRT groups were 31% versus 17%, respectively (p=0.03). Early TRT (p=0.03), and incomplete response to TRT (p=0.004) were negative predictors of OS. Significant positive prognostic factors for distant metastasis free survival were late TRT (p=0.03), and use of PCI (p=0.01). Use of carboplatin versus cisplatin for induction CT had no significant impact on OS (p=0.634), DFS (p=0.727), and MFS (p=0.309). Conclusions: Late TRT appeared to be superior to early TRT in LS-SCLC treatment in terms of complete response, OS and DMFS. Carboplatin or cisplatin can be combined with etoposide in the induction CT owing to similar survival outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Bayman¹,

Etiz²,

Akçay³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Life expectancy was shortened by .10 years among the current smokers compared with those who had never smoked. Adults who had quit smoking [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] or 45-54 years of age gained approximately 10, 9 and 6 years of life, respectively, compared with those who continued to smoke. This is in complete agreement with the UK observation.…”

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confidence: 99%

Updates in oncology

Sculier¹,

Meert²,

Berghmans³

2014

Eur Respir Rev

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The objective of this review is to report the Clinical Year in Review proceedings in the field of thoracic oncology that were presented at the 2013 European Respiratory Society Annual Congress in Barcelona, Spain. Various topics were reviewed, including: epidemiology, screening, histology, and treatment of nonsmall cell lung cancer and small cell lung cancer. @ERSpublications Lung cancer increasing in females; screening based on risk selection; doublet platinum-based chemotherapy recommended http://ow.ly/sjbR6 EpidemiologyEuropean cancer mortality predictions for lung cancer in 2013 report a continuing reduction in males, but a continuing increase in females [1]. For the first time in females, mortality from lung and breast cancers should be equivalent. In 2013, age-standardised mortality rates per 100 000 are estimated to be 37.1 in males and 13.9 in females for lung cancer.A US epidemiological study [2] has confirmed the data of the UK doctors' cohort [3]. The authors obtained smoking and smoking-cessation histories from 113 752 females and 88 496 males who were interviewed between 1997 and 2004. These data were related to the causes of deaths that occurred by the end of 2006 (8236 deaths in females and 7479 in males). The rate of death from any cause among current smokers was approximately three times that among those who had never smoked. The hazard ratios for females and males were 3.0 (99% CI 2.7-3.3) and 2.8 (99% CI 2.4-3.1), respectively. Life expectancy was shortened by .10 years among the current smokers compared with those who had never smoked. Adults who had quit smoking 25-34, 35-44 or 45-54 years of age gained approximately 10, 9 and 6 years of life, respectively, compared with those who continued to smoke. This is in complete agreement with the UK observation.Temporal trends in mortality across three time-periods (1959-1965, 1982-1988 and 2000-2010) were compared in terms of absolute and relative risks according to sex and self-reported smoking status in two historical and five pooled contemporary US cohort studies [4]. For females who were current smokers compared with females who had never smoked, the relative risk of death from lung cancer was 2. 73, 12.65 and 25.66 in the 1960s, 1980s and contemporary cohorts, respectively; corresponding relative risk for male current smokers compared with males who had never smoked was 12.22, 23.81 and 24.97 over the same time-periods, respectively. As in Europe, the risk of death by lung cancer from cigarette smoking in the USA continues to increase among females and the increased risks are now nearly identical for males and females; however, this is not the case in Europe.By pooled analysis, the International Lung Cancer Consortium determined the associations between prior lung diseases and the occurrence of lung cancer [5]. The analysis included 17 studies with 24 607 cases and

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“…Despite controversial findings in the literature [67][68][69], most data and guidelines support early thoracic radiotherapy beginning with the first or second cycle when cisplatin-based chemotherapy is used [26,39,68,[70][71][72], as the majority of studies indicate a benefit with early radiotherapy [73].…”

Section: Radiochemotherapymentioning

confidence: 99%

Treatment of limited disease small cell lung cancer: the multidisciplinary team

Glatzer

Rittmeyer²,

Müller

et al. 2017

Eur Respir J

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Phase III trial of concurrent thoracic radiotherapy with either first- or third-cycle chemotherapy for limited-disease small-cell lung cancer

Abstract: In LD-SCLC treatment, TRT starting in the third cycle of chemotherapy seemed to be noninferior to early TRT, and had a more favorable profile with regard to neutropenic fever.

Cited by 99 publications

References 16 publications

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Updates in oncology

Treatment of limited disease small cell lung cancer: the multidisciplinary team

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