Trends in stereotactic body radiation therapy for stage I small cell lung cancer

Stahl, John M.; Corso, Christopher D.; Verma, Vivek; Park, Henry S.; Nath, Sameer K.; Husain, Zain; Simone, Charles B.; Kim, Anthony W.; Decker, Roy H.

doi:10.1016/j.lungcan.2016.11.009

Cited by 82 publications

(54 citation statements)

References 22 publications

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“…The largest clinical study published on the use of SBRT in SCLC is a multi-institutional retrospective series in which 74 patients were treated for stage I disease. 6 In this study, 1- and 3-year local control rates were 97.4% and 96.1%, respectively, with 1- and 3-year OS rates of 69.6% and 34%. Despite very high rates of local control, distant relapse was common with a disease-free survival of 53.2% at 3 years.…”

Section: Discussionsupporting

confidence: 46%

“…However, a recently published study by Verma and colleagues showed an increasing trend over the past decade toward the use of stereotactic body radiation therapy (SBRT) with a median survival of 23 months in patients with early stage SCLC. 6 To date, there have been no studies comparing the outcomes of patients managed with surgery, conventional radiation therapy, or SBRT. The purpose of this study, therefore, was to compare treatment strategies for stage I SCLC using the NCDB.…”

Section: Introductionmentioning

confidence: 99%

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Comparing Treatment Strategies for Stage I Small-cell lung Cancer

Paximadis

Beebe‐Dimmer

George

et al. 2018

Clinical Lung Cancer

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Stage I small-cell lung cancer is increasing in incidence and there are limited clinical data upon which to make treatment recommendations for this population. In this study we compared outcomes for patients receiving surgery, stereotactic body radiation therapy (SBRT), and conventional radiation therapy. Patients who underwent surgery had the best survival outcomes. For those who did not have surgery, SBRT resulted in better outcomes that standard radiotherapy. Introduction: The diagnosis of stage I small-cell lung cancer (SCLC) is increasing in incidence with the advent of low-dose screening computed tomography. Surgery is considered the standard of care but there are very few data to guide clinical decision-making. The purpose of this study was to compare outcomes for patients receiving definitive surgery, stereotactic body radiation therapy (SBRT), or external beam radiation therapy (EBRT) for stage I SCLC. Patients and Methods: Patients with a primary diagnosis of stage I SCLC were identified in the National Cancer Database. Patients were defined as having a first course of treatment of either surgery, EBRT, or SBRT. Overall survival (OS) was determined using the Kaplane—Meier method and Cox proportional hazards regression methods were used to estimate risk of overall mortality. Results: A total of 2678 patients were included in the analysis. The 2- and 3-year OS for the whole cohort was 62% and 50%. Comparing treatment strategies in a multivariate model, surgical resection showed improved OS over EBRT (P < .001) and SBRT (P < .001), however, the OS benefit over SBRT did not persist for patients who underwent limited resection. When excluding patients who underwent surgery, SBRT showed improved OS compared with EBRT (P ¼ .04). Additional use of chemotherapy with any treatment modality resulted in improved OS (P < .001). Conclusion: In this hospital-based registry study, definitive surgical resection and use of chemotherapy resulted in improved survival for patients with early stage SCLC. For patients who are not candidates for surgery, SBRT may offer a survival benefit compared with standard EBRT.

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Section: Discussionsupporting

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Comparing Treatment Strategies for Stage I Small-cell lung Cancer

Paximadis

Beebe‐Dimmer

George

et al. 2018

Clinical Lung Cancer

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“…The NCDB is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society, which consists of deidentified information regarding tumor characteristics, patient demographics, and patient survival for approximately 70% of the U.S. population. [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The NCDB contains information not included in the Surveillance, Epidemiology, and End Results database, including details regarding use of systemic therapy and the dose of radiotherapy (RT). The data used in the study were derived from the deidentified NCDB NPC file (there were no other subsite files utilized).…”

Section: Ate Ri Als An D Me Tho Dsmentioning

confidence: 99%

Human papillomavirus and nasopharyngeal cancer

2018

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“…Previously, surgery was not considered to be a standard therapy for SCLC. An inquiry into the National Cancer Data Base (NCDB) demonstrated that surgery in cases of SCLC increased from 14.9% to 28.5% between 2004 and 2013 . Such an increase might be explained in part by the development of low dose CT screening and PET scans.…”

Section: Discussionmentioning

confidence: 99%

Does surgically resected small‐cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation?

Lou

Zhong

et al. 2020

Thoracic Cancer

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Background It has previously been demonstrated that surgically resected small‐cell lung cancer (SCLC) patients could benefit from prophylactic cranial irradiation (PCI). However, PCI in patients without lymph node involvement remains controversial. This study includes a larger sample size to evaluate the benefit of PCI therapy in this specific population. Methods The records of surgically resected SCLC patients without lymph node involvement (N0M0) in Shanghai Chest Hospital were retrospectively reviewed. Results Between January 2006 and May 2017, a total of 146 cases of surgically resected SCLC without lymph node involvement were included. A total of 46 patients received PCI therapy and 100 patients received no therapy. During the observation period, 12.0% (12/100) of the patients who did not receive PCI therapy developed brain metastases while 10.9% (5/46) of patients who received PCI therapy developed brain metastases. With regard to time to recurrence, no significant difference was observed among the groups (P = 0.798). Moreover, there was no significant difference in either the overall survival benefit (hazard ratio [HR] = 0.84, 95% confidence interval [CI]: 0.49–1.45, P = 0.532) or disease‐free survival rate (HR = 0.95, 95% CI: 0.52–1.75, P = 0.864). Conclusions The evidence obtained does not support PCI therapy in the management of surgically resected SCLC with no lymph node involvement. Key points Prophylactic cranial irradiation (PCI) remains controversial for resected small‐cell lung cancer (SCLC) without lymph node involvement. In this study, the results indicated that PCI does not reduce the risk of cerebral recurrence of resected p‐T1‐2N0M0 SCLC. This is the largest sample size study focused on PCI in resected p‐T1‐2N0M0 SCLC. Future revised versions of the guidelines should address this issue.

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Trends in stereotactic body radiation therapy for stage I small cell lung cancer

Cited by 82 publications

References 22 publications

Comparing Treatment Strategies for Stage I Small-cell lung Cancer

Comparing Treatment Strategies for Stage I Small-cell lung Cancer

Human papillomavirus and nasopharyngeal cancer

Does surgically resected small‐cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation?

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