Thoracic radiotherapy for limited-stage small cell lung cancer: Issues of timing, volumes, dose, and fractionation

Erridge, Sara; Murray, Nevin

doi:10.1053/sonc.2003.50017

Cited by 34 publications

(18 citation statements)

References 57 publications

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“…Improved long-term survival has been observed through combined modality therapy in LS-SCLC (Turrisi et al, 1999). The optimal timing of TRT, doses and fractionation schedules are currently debated (Takada et al, 2002;Erridge and Murray, 2003;Fried et al, 2004;Yee et al, 2010). Many studies have compared different TRT timing strategies, and have reported contrasting results.…”

Section: Discussionmentioning

confidence: 99%

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Bayman¹,

Etiz²,

Akçay³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: It is standard treatment to combine chemotherapy (CT) and thoracic radiotherapy (TRT) in treating patients with limited stage small cell lung cancer (LS-SCLC). However, optimal timing of TRT is unclear. We here evaluated the survival impact of early versus late TRT in patients with LS-SCLC. Materials and Methods: Follow-up was retrospectively analyzed for seventy consecutive LS-SCLC patients who had successfully completed chemo-TRT between January 2006 and January 2012. Patients received TRT after either 1 to 2 cycles of CT (early TRT) or after 3 to 6 cycles of CT (late TRT). Survival and response rates were evaluated using the Kaplan-Meier method and comparisons were made using the multivariate Cox regression test. Results: Median follow-up was 24 (5 to 57) months. Carboplatin+etoposide was the most frequent induction CT (59%). Median overall, disease free, and metastasis free survivals in all patients were 15 (5 to 57), 5 (0 to 48) and 11 (3 to 57) months respectively. Late TRT was superior to early TRT group in terms of response rate (p=0.05). 3 year overall survival (OS) rates in late versus early TRT groups were 31% versus 17%, respectively (p=0.03). Early TRT (p=0.03), and incomplete response to TRT (p=0.004) were negative predictors of OS. Significant positive prognostic factors for distant metastasis free survival were late TRT (p=0.03), and use of PCI (p=0.01). Use of carboplatin versus cisplatin for induction CT had no significant impact on OS (p=0.634), DFS (p=0.727), and MFS (p=0.309). Conclusions: Late TRT appeared to be superior to early TRT in LS-SCLC treatment in terms of complete response, OS and DMFS. Carboplatin or cisplatin can be combined with etoposide in the induction CT owing to similar survival outcomes.

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Section: Discussionmentioning

confidence: 99%

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Bayman¹,

Etiz²,

Akçay³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Although many studies have addressed this issue, the optimal timing of the radiation is not yet elucidated (Payne et al, 1994;Erridge and Murray, 2003). Takada et al (2002) reported a phase III study comparing concurrent and sequential radiation in combination with cisplatin and etoposide.…”

Section: Discussionmentioning

confidence: 99%

Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

Baas

Belderbos

Senan³

et al. 2006

Br J Cancer

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To improve the prognosis of limited stage small cell lung cancer (LS-SCLC) the addition of concurrent thoracic radiotherapy to a platinum-containing regimen is important. In the Netherlands, we initiated a multicenter, phase II study, of the combination of four cycles of carboplatin (AUC 5), paclitaxel (200 mg m À2) and etoposide (2 Â 50 mg orally for 5 days) combined with 45 Gy (daily fractions of 1.8 Gy). The radiation was given to the involved field and concurrently with the second and third chemotherapy cycle. Patients with a partial or complete response received prophylactic cranial irradiation to a dose of 30 Gy. From January 1999 to December 2001, 37 of the 38 patients with LS-SCLC entered were eligible for toxicity analysis and response. Grade 3 and 4 haematological toxicity occurred in 57% (21/37) with febrile neutropenia in 24% (9/37). There were no treatment-related deaths or other grade 4 toxicity. Grade 3 toxicities were oesophagitis (27%), radiation pneumonitis (6%), anorexia (14%), nausea (16%), dyspnea (19%) and lethargy (22%). The objective response rate was 92% (95% confidence interval (CI) 80 -98%) with a median survival time of 19.5 months (95% CI 12.8 -29.2). The 1-, 2-and 5-year survival rate was 70, 47 and 27%, respectively. In field local recurrences occurred in six patients. Distant metastases were observed in 19 patients of which 13 in the brain. This study indicates that combination chemotherapy with concurrent involved-field radiation therapy is an effective treatment for LS-SCLC. Despite PCI, the brain remained the most important site of recurrence.

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“…Several studies suggest that concurrent chemotherapy and thoracic radiotherapy yield better results [1,7,8,17,31].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effectiveness of “Late” and “Early” Prophylactic Cranial Irradiation in Patients with Limited-Stage Small Cell Lung Cancer

2010

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Thoracic radiotherapy for limited-stage small cell lung cancer: Issues of timing, volumes, dose, and fractionation

Cited by 34 publications

References 57 publications

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

Comparison of the Effectiveness of “Late” and “Early” Prophylactic Cranial Irradiation in Patients with Limited-Stage Small Cell Lung Cancer

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