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http://dx.doi.org/10.7314/APJCP.2014.15.15.6263

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

Bayman, Evrim (Department of Radiation Oncology, Medical Faculty, Eskisehir Osmangazi University)
Etiz, Durmus (Department of Radiation Oncology, Medical Faculty, Eskisehir Osmangazi University)
Akcay, Melek (Department of Radiation Oncology, Medical Faculty, Eskisehir Osmangazi University)
Ak, Guntulu (Department of Chest Diseases, Medical Faculty, Eskisehir Osmangazi University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.15, 2014 , pp. 6263-6267 More about this Journal
Abstract
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.
Keywords
Small cell lung cancer; chemotherapy; radiotherapy; prophylactic cranial irradiation; prognosis;
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