Guideline for the Initial Management of Small Cell Lung Cancer (Limited and Extensive Stage) and the Role of Thoracic Radiotherapy and First-line Chemotherapy

Sun, Alexander; Durocher-Allen, Lisa; Ellis, Peter; Ung, Yee C.; Goffin, John R.; Ramchandar, Kevin; Darling, Gail

doi:10.1016/j.clon.2018.06.008

Cited by 26 publications

(22 citation statements)

References 37 publications

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“…Stacey et al [11] reported that PS and the presence of comorbidities were the most common factors that affected clinical oncologists not to recommend chemotherapy, and most patients rejected chemotherapy mainly because of their concerns about toxicity. Our COX analysis also demonstrated that surgery and radiation were positively associated with better survival, which is consist with other recent studies [26][27][28][29]. In a retrospective analysis of 366 SCLC patients receiving chemotherapy or chemoradiotherapy [28], Kanaji et with thoracic radiotherapy correlated with longer OS compared with chemotherapy alone (13 months vs. 9 months) [19].…”

Section: Discussionsupporting

confidence: 89%

Advanced age is not the decisive factor in chemotherapy of small cell lung cancer: a population-based study

Rao

Zhou

Mei

et al. 2022

Aging

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Objective: There is limited research on the impact of chemotherapy on the prognosis of different age group patients with small cell lung cancer (SCLC). The aim of this study was to explore the impact of chemotherapy on survival prognosis of elderly patients with SCLC. Methods: Based on the Surveillance, Epidemiology and End Results (SEER) database, 57,460 SCLC patients between 2004 and 2015 were identified and divided into a ≤ 80 years group (n = 50,941) and a >80 years group (n = 6,519). Confounding factors were controlled by propensity score matching (PSM) analysis. Kaplan Meier (KM) analysis was performed to determine the impact of chemotherapy on overall survival (OS) and lungcancer specific survival (LCSS) of the patients. Other variables that could affect survival of SCLC patients were also examined by COX analysis. Results: KM analysis showed that both OS and LCSS were improved in chemotherapy group compared to those in non-chemotherapy group (log rank P < 0.001) in both age groups after PSM. Cox analysis demonstrated the survival benefit of chemotherapy in both ≤ 80 years group (OS: HR 0.435; 95% CI 0.424-0.447; LCSS: HR 0.436; 95% CI 0.424-0.448) and >80 years group (OS: HR 0.424; 95% CI 0.397-0.451; LCSS: HR 0.415; 95% CI 0.389-0.444). Additionally, the following parameters had a negative impact on survival of elderly patients: male sex, tumor location in main bronchus, increased stage, bilateral tumor, no surgery or radiation, and lower median household income. Conclusions: Elderly patients with SCLC should be encouraged to receive chemotherapy provided their general conditions permit. www.aging-us.com 4828 AGING at diagnosis [5], and there is an increasing trend in the proportion of SCLC patients in the age group older than 75 years according to a study from Hebei, China [6].

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Section: Discussionsupporting

confidence: 89%

Advanced age is not the decisive factor in chemotherapy of small cell lung cancer: a population-based study

Rao

Zhou

Mei

et al. 2022

Aging

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“…Eligible CPGs were published from 2008 to 2018, with first authors based in USA (n = 9), Canada (n = 5), the Netherlands (n = 1), England (n = 1), Italy (n = 1), Switzerland (n = 1), Scotland (n = 1), Singapore (n = 1), China (n = 1), France (n = 1), Australia (n = 1), Spain (n = 1), and Saudi Arabia (n = 1); additionally one CPG’s first author listed the Netherlands and Belgium. 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 The CPGs were funded and/or developed by professional associations or societies (n = 26). Four CPGs made mention of CIMs.…”

Section: Resultsmentioning

confidence: 99%

Complementary and integrative medicine mention and recommendations: A systematic review and quality assessment of lung cancer clinical practice guidelines

Nault

Nazir

2021

Integrative Medicine Research

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Background Complementary and integrative medicine (CIM) use is widely sought by those diagnosed with cancer, with up to 50% of lung cancer patients seeking these therapies in the United States. The purpose of this study was to identify the quantity and assess the quality of CIM recommendations in clinical practice guidelines (CPGs) for the treatment and/or management of lung cancer. Methods A systematic review was conducted to identify lung cancer CPGs. MEDLINE, EMBASE and CINAHL were searched from 2008 to 2018, along with the Guidelines International Network and the National Center for Complementary and Integrative Health websites. Eligible guidelines containing recommendations for the treatment and/or management of lung cancer were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Results From 589 unique search results, 4 guidelines mentioned CIM, of which 3 guidelines made CIM recommendations. Scaled domain percentages from highest to lowest were: scope and purpose (82.4% overall, 76.9% CIM), clarity and presentation (96.3% overall, 63.0% CIM), editorial independence (61.1% overall, 61.1% CIM), rigour of development (62.5% overall, 54.9% CIM), stakeholder involvement (66.7% overall, 42.6% CIM) and applicability (29.9% overall, 18.8% CIM). Quality varied within and across guidelines. Conclusion Guidelines that scored well could serve as a framework for discussion between patients and healthcare professionals regarding use of CIM therapies in the context of lung cancer. Guidelines that scored lower could be improved according to the AGREE II instrument, with insight from other guidelines development resources.

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“…Treatment patterns for this cohort of patients reflect guideline-recommended therapies [ 13 ]. The majority of patients with LS SCLC received chemotherapy and thoracic radiation, with many receiving PCI as well.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Relapse in Small Cell Lung Cancer: Competing Risks of Thoracic versus CNS Relapse

2021

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Introduction: Treatment algorithms for small cell lung cancer (SCLC) are determined largely by the Veterans Affairs Lung Cancer Staging Group (VALCSG) staging (limited (LS) versus extensive (ES) stage). Relapse occurs frequently; however, patterns of relapse, in particular the competing risk of thoracic and central nervous system relapse, are not well described. This study describes patterns of relapse in SCLC patients treated at a large tertiary institution in Ontario, Canada. Materials and Methods: A retrospective cohort of SCLC patients treated at the Juravinski Cancer Centre was reviewed. Data were abstracted from the medical record on demographic, disease, treatment and outcome variables. The primary outcome was a description of the patterns of relapse stratified by disease stage. Multivariate analysis was performed to identify prognostic variables for thoracic and CNS relapse. Results: Two hundred and twenty nine patients were treated during the study period (LS—83, ES—146). Relapse occurred in the majority of patients (isolated thoracic—28%, isolated CNS—9%, extrathoracic—9%, thoracic/extrathoracic—14%, systemic and CNS—13%). The median OS was consistent with published data (LS—21.8 months, ES—8.9 months). ES disease and elevated LDH were prognostic for increased thoracic relapse, whereas poor PS and older age were prognostic for lower central nervous system (CNS) relapse. Discussion: Thoracic relapse and CNS relapse represent competing risks for patients with SCLC. Decisions about incorporating thoracic or CNS radiation are complex. More research is needed to incorporate performance status and LDH into treatment algorithms.

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Guideline for the Initial Management of Small Cell Lung Cancer (Limited and Extensive Stage) and the Role of Thoracic Radiotherapy and First-line Chemotherapy

Cited by 26 publications

References 37 publications

Advanced age is not the decisive factor in chemotherapy of small cell lung cancer: a population-based study

Advanced age is not the decisive factor in chemotherapy of small cell lung cancer: a population-based study

Complementary and integrative medicine mention and recommendations: A systematic review and quality assessment of lung cancer clinical practice guidelines

Patterns of Relapse in Small Cell Lung Cancer: Competing Risks of Thoracic versus CNS Relapse

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