&lt;p&gt;Thoracic Radiotherapy Benefits Elderly Extensive-Stage Small Cell Lung Cancer Patients with Distant Metastasis&lt;/p&gt;

Qi, Jing; Xu, Liming; Sun, Jian; Wang, Xin; Zhao, Lujun

doi:10.2147/cmar.s221225

Cited by 5 publications

(6 citation statements)

References 33 publications

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“…In our study, the median PFS2 was 2.400 months. Our results were similar to Qi et al's study (20); however, our study differs from other studies as it included only patients with extensive disease and consisted of two stages, both of which were prospective studies. Further exploration with the inclusion of the survival time of patients with ES-SCLC is needed.…”

Section: Discussionsupporting

confidence: 90%

The benefits of etoposide capsules as maintenance therapy for patients with extensive-stage small cell lung cancer: a prospective two-stage, two-center study

Zhang¹,

Duan²,

He³

et al. 2021

J Thorac Dis

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Background: Due to the high incidence and mortality of lung cancer, and etoposide is the standard firstline chemotherapy for small cell lung cancer, to evaluate the efficacy and safety of etoposide capsules at different doses as maintenance therapy for patients with extensive-stage small cell lung cancer (ES-SCLC) who show a response to etoposide plus platinum. Methods: The study was divided into two stages: stage I, a single-center, one-arm prospective study, and stage II, a multicenter, controlled non-randomized prospective study (patients were chosen from ClinicalTrials.gov Identifier: NCT02179528). All patients received six cycles of etoposide plus platinum. Patients who were evaluated as complete remission (CR) or partial remission (PR) entered the maintenance treatment (MT) (etoposide capsule, once a day for 20 days, every 28 days as a cycle, until disease progression). In stage I, the dose of etoposide was 25 mg; in stage II, patients were non-randomized into etoposide capsule (25 mg/50 mg) and observation groups. In this study, the primary endpoints were progression-free survival (PFS) and safety; the secondary endpoint was overall survival (OS). Toxicity was graded according to the Common Terminology Criteria for Adverse Events v3.0. Results: Ninety-two patients were enrolled. In stage I, the median PFS was 6.700 months (95% CI: 6.408-6.992). In stage II, the median PFS of the MT group was better than that in the NMT group (8.930 vs. 5.900 months, P=0.002). In the pooled analysis, the overall median PFS of the MT group was better than that of the NMT group (7.870 vs. 5.900 months, P=0.003). However, there was no significant difference in OS between the groups (15.030 vs. 14.330 months, P=0.813). Multivariate Cox regression analysis showed that maintenance therapy was an independent protective factor for PFS in patients with ES-SCLC. Conclusions: Etoposide capsules as maintenance therapy significantly prolonged the PFS of patients with ES-SCLC who responded to etoposide plus platinum, with acceptable tolerability.

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Section: Discussionsupporting

confidence: 90%

The benefits of etoposide capsules as maintenance therapy for patients with extensive-stage small cell lung cancer: a prospective two-stage, two-center study

Zhang¹,

Duan²,

He³

et al. 2021

J Thorac Dis

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“…The pooled results showed that the addition of TRT still improved the prognosis of patients over 65 years of age. In addition, previous studies have demonstrated that ES-SCLC patients with a single metastatic site were more suitable for radiotherapy as they had lower disease burden (16,24,25). However, our study did not observe the benefit of TRT for OS in patients with only one organ metastasis.…”

Section: Discussioncontrasting

confidence: 89%

“…A total of 4,754 studies were excluded by screening titles and abstracts. After reading the full text of the remaining 237 studies, 12 studies were eventually included in the meta-analysis: 3 RCTs and 9 retrospective studies (5)(6)(8)(9)(10)(11)(16)(17)(18)(19)(20)(21). The selection process of the study is shown in Figure 1.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…The basic characteristics of the included studies are shown in Table 1. Four retrospective studies performed PSM (8,(16)(17)(18). Two retrospective studies evaluated the role of TRT in patients aged ≥65 years (16,19).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Four retrospective studies performed PSM (8,(16)(17)(18). Two retrospective studies evaluated the role of TRT in patients aged ≥65 years (16,19). One retrospective study analyzed the prognosis of patients with oligometastases and polymetastases separately (18).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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Role of thoracic radiotherapy in extensive stage small cell lung cancer: a systemic review and meta-analysis

Li¹,

Zhou²,

Xu³

et al. 2021

Ann Transl Med

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Background: The role of thoracic consolidation radiotherapy in patients with extensive stage small cell lung cancer (ES-SCLC) remains controversial. This study aimed to evaluate the efficacy of thoracic radiotherapy (TRT) in these patients.Methods: A systematic literature search was performed in PubMed, Embase, and the Cochrane library to identify qualified clinical studies. The hazard ratios (HRs) and 95% confidence intervals (CIs) of overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRFS) were extracted, and toxicity of the TRT group versus non-TRT group was analyzed.Results: A total of 12 studies were included in this meta-analysis, including 936 patients in the TRT group and 1,059 patients in the non-TRT group. The combined results showed that TRT significantly improved OS (HR =0.65; 95% CI: 0.55-0.77, P<0.00001), PFS (HR =0.64; 95% CI: 0.56-0.72, P<0.00001) and LRFS (HR =0.38, 95% CI: 0.26-0.53, P<0.00001). Subgroup analysis showed that OS benefits were observed in patients receiving sequential TRT (HR =0.67; 95% CI: 0.54-0.84, P=0.0006). The addition of TRT significantly improved OS in patients over 65 years of age (HR =0.55; 95% CI: 0.40-0.74, P=0.0001). For patients with only one organ metastasis, there was no significant difference in OS between the two groups (HR =0.61; 95% CI: 0.36-1.01, P=0.06). There was no statistical difference in hematologic toxicity (leukopenia, thrombocytopenia, anemia) and non-hematologic toxicity (nausea or vomiting) between the two groups.The incidence of grade ≥3 esophageal toxicity was 4.6% in the TRT group and 0% in the non-TRT group (P=0.0001). Grade ≥3 bronchopulmonary toxicity was 2.9% in the TRT group and 0.8% in the non-TRT group (P=0.02).Conclusions: TRT improves OS, PFS and LRFS in patients with ES-SCLC, with a low increase in esophageal and bronchopulmonary toxicity. More randomized controlled trials (RCTs) are expected to confirm our conclusions.

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Role of Thoracic Radiation Therapy in Extensive Disease Small Cell Lung Cancer

et al. 2021

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<p>Thoracic Radiotherapy Benefits Elderly Extensive-Stage Small Cell Lung Cancer Patients with Distant Metastasis</p>

Cited by 5 publications

References 33 publications

The benefits of etoposide capsules as maintenance therapy for patients with extensive-stage small cell lung cancer: a prospective two-stage, two-center study

The benefits of etoposide capsules as maintenance therapy for patients with extensive-stage small cell lung cancer: a prospective two-stage, two-center study

Role of thoracic radiotherapy in extensive stage small cell lung cancer: a systemic review and meta-analysis

Role of Thoracic Radiation Therapy in Extensive Disease Small Cell Lung Cancer

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