Clinical Outcomes of Extensive Stage Small Cell Lung Carcinoma Patients Treated With Consolidative Thoracic Radiotherapy

Giuliani, Meredith; Atallah, Soha; Sun, Alexander; Bezjak, Andrea; Le, Lisa W.; Brade, Anthony; Cho, John; Leighl, Natasha B.; Shepherd, Frances A.; Hope, Andrew

doi:10.1016/j.cllc.2011.03.028

Cited by 41 publications

(24 citation statements)

References 19 publications

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“…Consolidative TRT is therefore shown to control the locoregional disease in the majority of patients with minimal acute toxicity, though distant failure remains a significant problem (32). In the present study, SCLC progression and distant metastasis were observed in 23 and 39 patients in the ChT/TRT group, and 41 and 35 patients in the ChT group, respectively.…”

Section: Characteristicmentioning

confidence: 52%

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

Luan

Wang

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to evaluate the effect of 3-dimensional conformal thoracic radiotherapy (TRT) on extensive-stage small-cell lung cancer (ES-SCLC). A total of 165 patients with ES-SCLC were enrolled in the present study, including 82 patients receiving chemotherapy combined with TRT (the ChT/TRT group) and 83 patients receiving chemotherapy alone (the ChT group). The overall survival (OS) and progression-free survival (PFS) rates were compared between the ChT/TRT and ChT groups, and the prognostic factors for OS rate were identified. It was found that the patients had a median OS time of 15 months, and 2-and 5-year OS rates of 31.5 and 2.4%, respectively. The 2-and 5-year OS rates were 35.3 and 2.4% in the ChT/TRT group, and 14.5 and 2.4% in the ChT group, respectively (P<0.05). The 1-and 2-year PFS rates were 35.4 and 6.0% in the ChT/TRT group, and 20.5 and 6.0% in the ChT group, respectively (P<0.05). The median PFS was 11 months in the 20 patients receiving TRT at 45 Gy/30 fractions twice daily, and 9 months in the 22 patients receiving TRT at 60 Gy/30 fractions daily (P=0.043). Multivariate analysis revealed that receiving ≥4 cycles of chemotherapy (P=0.001) and TRT (P=0.008) were favorable prognostic factors for OS. It was concluded that the addition of TRT improves the OS and PFS rates of patients with ES-SCLC, and TRT administration at 45 Gy/30 fractions twice daily is feasible and tolerable for the treatment of ES-SCLC. Thus, TRT and receiving ≥4 cycles of chemotherapy are independent, favorable prognostic factors for OS in patients with ES-SCLC. IntroductionLung cancer is a leading cause of cancer-associated mortality worldwide, with >1 million mortalities annually (1). Small-cell lung cancer (SCLC) accounts for 10-15% of lung cancer cases (2). It is estimated that 70% of patients with SCLC have extensive-stage SCLC (ES-SCLC) at the time of diagnosis (3).Currently, the first-line therapy for ES-SCLC remains dependent on platinum-based chemotherapy with cisplatin-etoposide (EP) (4). The addition of thoracic radiotherapy (TRT) is suggested in certain patients due to its confirmed value in the improvement of the overall survival (OS) rate (5,6). Although SCLC is sensitive to chemotherapy and radiotherapy, with a 60-80% response rate, the median survival rate of patients with ES-SCLC is estimated to be only 7-12 months following 4-6 cycles of standard chemotherapy (4).Systemic chemotherapy in combination with concurrent TRT have been demonstrated to be effective in the treatment of limited-stage SCLC (LS-SCLC) by improving the progression-free survival (PFS) and OS rates (7-9). The National Comprehensive Cancer Network (NCCN) guidelines recommend that TRT should be initiated during the first or second cycles of chemotherapy in cases of LS-SCLC at 45 Gy administered twice per day in 1.5 Gy fractions, or 60-70 Gy in 2 Gy daily fractions (10-12). However, the effect of TRT on ES-SCLC remains unknown. The present retrospective study evaluated the effect of 3-dimensional (3D) conformal ...

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Section: Characteristicmentioning

confidence: 52%

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

Luan

Wang

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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“…A single-institution randomized trial (67) demonstrated an improvement in both local control and OS in patients with a complete distant response and at least partial local response to chemotherapy who received chemotherapy with concurrent thoracic radiotherapy and PCI versus continued chemotherapy and PCI. A single-arm phase II trial (68) and retrospective series also demonstrated an improvement in local disease control with thoracic radiotherapy in carefully selected populations of patients with limited extra-thoracic disease burden (69,70). The CREST Trial/NTR1527 (71) randomized 498 patients with ES-SCLC and response to chemotherapy to thoracic radiotherapy to 30 Gy in 10 fractions and PCI versus PCI alone.…”

Section: Extensive Stage Sclc: Radiation Therapymentioning

confidence: 99%

Current standards for clinical management of small cell lung cancer

Farago

Keane

2018

Transl. Lung Cancer Res.

199

158

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“…Consolidative trt (ctrt) after chemotherapy has the potential to benefit patients with es-sclc, and although emerging evidence in the literature supports its use, whether that evidence has translated into consistent practice among radiation oncologists (ros) is not clear [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists

et al. 2016

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Clinical Outcomes of Extensive Stage Small Cell Lung Carcinoma Patients Treated With Consolidative Thoracic Radiotherapy

Cited by 41 publications

References 19 publications

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

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

Current standards for clinical management of small cell lung cancer

Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists

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