Survival in Limited Disease Small Cell Lung Cancer According to N3 Lymph Node Involvement

Valan, Christine Damgaard; Slagsvold, Jens Erik; Halvorsen, Tore; Bremnes, Roy M.; Brunsvig, Paal; Brustugun, Odd Terje; Fløtten, Øystein; Levin, Nina Jackson; Sundstrøm, Stein; Grønberg, Bjørn Henning

doi:10.21873/anticanres.12296

Cited by 2 publications

(3 citation statements)

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“…Radiotherapy alone or in combination with systemic therapies is commonly used for treating locally advanced lung cancers (2). As the prognosis of these patients is often limited, considerable research is carried out to improve their outcomes (9)(10)(11)(12)(13). If radiotherapy is administered, high doses are often required, particularly if the treatment approach is considered curative.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

et al. 2019

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Background/Aim: Radiotherapy of locally advanced lung cancer often requires high doses potentially leading to pneumonitis. This study evaluated the rate of symptomatic pneumonitis and characteristics in these patients. Patients and Methods: This study included 278 patients irradiated for locally advanced lung cancer between 2016 and 2019. In patients experiencing symptomatic pneumonitis, patient and treatment characteristics were analyzed. Results: Pneumonitis was diagnosed in 21 patients (7.6%) after a median of 9 (1-23) weeks. Ipsilateral lungs received mean doses >13 Gy in 21 (100%) and >20 Gy in 15 patients (71.4%). Seventeen patients (81.0%) received chemotherapy and/or immunotherapy, 12 (57.1%) had significant cardiovascular disease (all 21 patients had risk factors), 11 (52.4%) were heavy smokers (≥40 pack years), 7 (33.3%) were aged ≥74 years, 5 (23.8%) had chronic inflammatory disease and 4 (19.0%) had previous tumors. Conclusion: Overall pneumonitis rate was 7.6%. Frequent characteristics included high mean lung doses, systemic treatment, cardiovascular disease (and risk factors), heavy smoking, older age, chronic inflammatory disease and history of a previous tumor.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

et al. 2019

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“…5 Our results were consistent with a recent study of N3 LS-SCLC. 7 According to previously published results, the prognosis of LS-SCLC is better than ES-SCLC. 9 Although some studies have found that patients with broader lymph node metastasis showed decreased survival, there are few trials that focus on survival of LS-SCLC with different N staging.…”

Section: Discussionmentioning

confidence: 95%

“…A recent study showed that N3 LS-SCLC treated with concurrent CRT still had a lower 3-year survival than heterogeneous LS-SCLC patients. 7 In addition, our previous work found that patients with high-dose TRT showed a lower 2-year survival than those with low-dose TRT in SCLC patients with superior vena cava syndrome (SVCS, most of them are N3). 8 Therefore, the prognosis of N3 LS-SCLC remains poor and the best treatment model is unclear.…”

Section: Introductionmentioning

confidence: 99%

Sequential Versus Concurrent Thoracic Radiotherapy in Combination With Cisplatin and Etoposide for N3 Limited-Stage Small-Cell Lung Cancer

et al. 2020

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At present, concurrent chemoradiotherapy (CRT) is considered the standard treatment of limited-stage small cell lung cancer (LS-SCLC). However, LS-SCLC is highly heterogeneous in the T stage, N stage, and prognosis. Increasing evidence has shown that individual treatment should be considered when treating LS-SCLC patients. The aim of the present study was to explore the optimal combination model of thoracic radiotherapy (TRT) and chemotherapy in N3 LS-SCLC. We retrospectively analyzed 93 N3 LS-SCLC patients treated in the Department of Oncology of Binzhou Medical University Hospital (Shandong, China) between March 2010 and October 2015. A total of 52 (52/93; 55.9%) patients received sequential CRT, and 41 (41/93; 44.1%) patients received concurrent CRT. All patients received 4-6 cycles of chemotherapy and TRT (50-60 Gy). The median follow-up time was 25.4 months (range was 6-65 months).The overall response rate was 88.5% in the sequential CRT group (9.6% complete response rate and 78.8% partial response rate) and 90.2% in the concurrent CRT group (14.6% complete response rate and 75.6% partial response rate). The PFS and OS were 15.4 months and 19.1 months in sequential CRT group, and 16.9 months and 20.5 months in concurrent CRT group. There was no significant difference in treatment response rate, PFS, and OS between sequential and concurrent CRT patients. The most common treatment-related toxicities were nausea/vomiting, neutropenia, and esophagitis. In conclusion, when concurrent CRT is performed in N3 LS-SCLC patients, tolerance to treatment should be fully considered. In our study, sequential CRT and concurrent CRT showed the same efficacy, and sequential CRT demonstrated better tolerance. However, these results require confirmation in future follow-up studies.

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Survival in Limited Disease Small Cell Lung Cancer According to N3 Lymph Node Involvement

Abstract: There were no survival differences between the N3 subcategories, suggesting that all N3 disease should be considered as LD.

Cited by 2 publications

References 8 publications

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

Sequential Versus Concurrent Thoracic Radiotherapy in Combination With Cisplatin and Etoposide for N3 Limited-Stage Small-Cell Lung Cancer

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