Chemoradiotherapy for Limited-Stage Small Cell Lung Cancer and Interstitial Lung Abnormalities

Abstract

Purpose: Patients with lung cancer and interstitial lung disease treated with radiotherapy have been reported to be at a risk of developing radiation pneumonitis. However, the association between interstitial lung abnormalities (ILA) and radiation pneumonitis in patients with limited-stage small cell lung cancer (LS-SCLC) remains unclear. Furthermore, the prognosis is unclear for patients with SCLC and ILA treated with chemoradiotherapy. We investigated the impact of ILA on radiation pneumonitis and assessed the prognosis of patients with LS-SCLC and ILA treated chemoradiotherapy. Methods and materials: We retrospectively reviewed the medical records of 149 patients with LS-SCLC who received first-line treatment between January 2009 and December 2016. Results: In a univariate analysis, the patients with ILA showed a higher incidence rate of radiation pneumonitis compared with those without ILA (64% vs. 10%); multivariate analysis confirmed that ILA was significantly associated with the incidence of radiation pneumonitis. In the univariate analysis, patients with ILA showed poorer overall survival than those without ILA (median, 18.9 vs. 67.9 months). Multivariate analysis showed that ILA was a significant independent negative prognostic factor. However, the 2-year and 5-year survival rates for the patients with ILA treated with chemoradiotherapy were 36% and 26%, respectively; for those treated with chemotherapy alone were 8% and 0%, respectively.Conclusions: ILA was a predictive factor for radiation pneumonitis in patients with LS-SCLC treated with chemoradiotherapy. The prognosis of the patients with LS-SCLC and ILA was poor; however, some patients with ILA treated chemoradiotherapy achieved long-term survival.

Different clinical characteristics and survival between surgically resected pure and combined small cell lung cancer

“…As reported in previous studies, the incidence of C-SCLC accounts for 2%-28% of all SCLC patients. [4][5][6] Because of the complexity of diagnosis and the lack of C-SCLC clinical standardization, most previous studies take pure and combined SCLC as a whole. [4][5][6] As a result, there are limited studies about the differences between pure and combined SCLC.…”

“…[4][5][6] Because of the complexity of diagnosis and the lack of C-SCLC clinical standardization, most previous studies take pure and combined SCLC as a whole. [4][5][6] As a result, there are limited studies about the differences between pure and combined SCLC. Most SCLC patients are found to be at an advanced stage of disease, and only 30% with early stage might benefit from surgery.…”

“…As reported in previous studies, the incidence of C‐SCLC accounts for 2%–28% of all SCLC patients. [ 4–6 ]…”