Prognostic role of patient gender in limited-disease small-cell lung cancer treated with chemoradiotherapy

Roengvoraphoj, Olarn; Eze, Chukwuka; Niyazi, Maximilian; Li, Minglun; Hildebrandt, Guido; Fietkau, Rainer; Belka, Claus; Manapov, Farkhad

doi:10.1007/s00066-016-1073-x

Cited by 14 publications

(9 citation statements)

References 17 publications

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“…This difference might be explained by a better response to chemotherapy and radiotherapy in women as it was found by previous studies. 31 , 32 In contrast to women, men were more likely to receive a mere symptomatically treatment in a population-based cohort. 33 Thus, in an ecological study, a potential survival advantage due to radiotherapy might be weaker in men than in women.…”

Section: Discussionmentioning

confidence: 96%

Number of radiotherapy treatment machines in the population and cancer mortality: an ecological study

Medenwald

Vordermark

Dietzel

2018

CLEP

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ObjectivesThe aim of this study was to assess the association between the number of radiotherapy treatment machines (RTMs) in the population and incidence-adjusted cancer mortality.MethodsData on cancer incidence and mortality were obtained from the GLOBOCAN project (only high-quality data, C3, or higher according to GLOBOCAN quality label), information on the number of RTMs from the Directory of Radiotherapy Centers database, and remaining data from the World Bank and World Health Organization database. We used linear regression models to assess the associations between RTM per 10,000,000 inhabitants (logarithmized) and the log-transformed mortality/incidence ratio. Models were adjusted for public health variables. To assess the bias due to unobserved confounders, mortality from leukemia was considered as a negative control. Here radiotherapy treatment is less frequently applied, but a common set of confounders is shared with cancer types where radiotherapy plays a stronger role, enabling us to estimate the bias due to confounding of unmeasured parameters. To assess an exposure–effect size relationship, estimated cancer type-specific estimates were related to the proportion of subjects receiving radiotherapy.ResultsWe found an inverse linear relationship between RTM in the population and the cancer mortality to incidence ratio for prostate cancer (14.1% per doubling of RTM; 95% CI: 0.1%–26.1%), female breast cancer (12.3%; 95% CI: 2.7%–20.9%), and lung cancer in women (11.2%; 95% CI: 4.3%–17.6%). There was no evidence for bias due to unobserved confounders after covariate adjustment. For women, an exposure-effect size relationship was found (P=0.02).ConclusionIn this ecological study, we found evidence that the population density of RTM is related to cancer mortality independently of other public health parameters.

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Section: Discussionmentioning

confidence: 96%

Number of radiotherapy treatment machines in the population and cancer mortality: an ecological study

Medenwald

Vordermark

Dietzel

2018

CLEP

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Section: Discussionmentioning

confidence: 99%

“…22 In a patient cohort with limited disease SCLC treated with definitive chemoradiotherapy, female gender was significantly associated with longer OS and brain metastasis-free survival. 23 In the present series, the prescribed dose with 48 Gy in 4 fractions or 50 Gy in 5 fractions was generally used. These dose fractions have been commonly used for patients with stage I NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Stereotactic Body Radiotherapy for Patients With Stage I Small-Cell Lung Cancer: Analysis of a Subset of the Japanese Radiological Society Multi-Institutional SBRT Study Group Database

Shioyama

Oda

Takayama

et al. 2018

Technol Cancer Res Treat

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Stereotactic body radiotherapy (SBRT) is widely used as a curative treatment option for stage I non-small-cell lung cancer, but for patients with stage I small-cell lung cancer, the role of stereotactic body radiotherapy is unclear. In this study, we retrospectively analyzed the outcomes of a subset of patients with stage I small-cell lung cancer treated with stereotactic body radiotherapy in the database of the Japanese Radiological Society-Multi-Institutional stereotactic body radiotherapy Study Group. The 43 patients treated with stereotactic body radiotherapy for stage I small-cell lung cancer between 2004 and 2012 at 11 Japanese institutions were studied: median age = 77 years; 32 (74%) males and 11 females; and 80% were medically inoperable. The clinical stage was IA in 31 and IB in 12. In all patients, the lung tumors were pathologically proven as small-cell lung cancer. A total dose of 48 to 60 Gy was administered in 4 to 8 fractions. The median biologically effective dose (α/β = 10 Gy) was 105.6 Gy. Chemotherapy and prophylactic cranial irradiation were administered in only 8 patients, respectively. The median follow-up time was 23.2 months. The 2-year overall survival, progression-free survival, and distant metastasis-free survival rates were 72.3%, 44.6%, and 47.2%, respectively. The 2-year local control was 80.2%. Regarding the patterns of failure, distant metastasis, lymph node metastasis, and local recurrence were observed in 47%, 28%, and 16% of patients, respectively. No ≥grade 3 stereotactic body radiotherapy-related toxicities were observed. Although stereotactic body radiotherapy was thus revealed to be effective for the local control of stage I small-cell lung cancer, the incidence of distant metastases was high. Further investigations of larger cohorts are needed, including analyses of the effects of combined chemotherapy.

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“…It is unclear if it is influenced by gender, with at least one study noting a significantly higher incidence of development of metachronous brain metastases and a shorter brain metastases free interval in men with limited stage disease. [ 12 ] Increasing pathologic stage correlates with higher incidence of brain metastases. Therapeutic management, such as the extent of resection (complete vs. incomplete) of the primary tumor influences this as well [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

State-of-the-art considerations in small cell lung cancer brain metastases

et al. 2017

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BackgroundSmall cell lung cancer (SCLC) frequently leads to development of brain metastases. These unfortunately continue to be associated with short survival. Substantial advances have been made in our understanding of the underlying biology of disease. This understanding on the background of previously evaluated and currently utilized therapeutic treatments can help guide the next steps in investigations into this disease with the potential to influence future treatments.DesignA comprehensive review of the literature covering epidemiology, pathophysiology, imaging characteristics, prognosis, and therapeutic management of SCLC brain metastases was performed.ResultsSCLC brain metastases continue to have a poor prognosis. Both unique aspects of SCLC brain metastases as well as features seen more universally across other solid tumor brain metastases are discussed. Systemic therapeutic studies and radiotherapeutic approaches are reviewed.ConclusionsA clearer understanding of SCLC brain metastases will help lay the framework for studies which will hopefully translate into meaningful therapeutic options for these patients.

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Prognostic role of patient gender in limited-disease small-cell lung cancer treated with chemoradiotherapy

Abstract: In this heterogeneous LD SCLC patient cohort treated with definitive CRT, female gender was significantly associated with longer BMFS and OS, as well as with a lower incidence of metachronous brain failure.

Cited by 14 publications

References 17 publications

Number of radiotherapy treatment machines in the population and cancer mortality: an ecological study

Number of radiotherapy treatment machines in the population and cancer mortality: an ecological study

Clinical Outcomes of Stereotactic Body Radiotherapy for Patients With Stage I Small-Cell Lung Cancer: Analysis of a Subset of the Japanese Radiological Society Multi-Institutional SBRT Study Group Database

State-of-the-art considerations in small cell lung cancer brain metastases

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