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Erschienen in: Strahlentherapie und Onkologie 1/2012

01.01.2012 | Original article

Chemoradiotherapy duration correlates with overall survival in limited disease SCLC patients with poor initial performance status who successfully completed multimodality treatment

verfasst von: F. Manapov, S. Klöcking, M Niyazi, C. Belka, G. Hildebrandt, R. Fietkau, G. Klautke

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2012

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Abstract

Background and purpose

Limited data concerning treatment-related prognostic factors in limited disease (LD) small-cell lung cancer (SCLC) patients with poor initial performance status (PS) who successfully completed chemoradiotherapy (CRT) are available.

Patients and methods

A total of 125 patients with initial PS WHO 2–3 who successfully completed CRT were retrospectively reviewed. Thoracic radiation therapy (TRT) was applied in the concurrent (group 1) or sequential (group 2) mode. Influence of treatment type, time from diagnosis to start of TRT, number of chemotherapy cycles, prophylactic cranial irradiation (PCI), occurrence of brain metastases (BMs), and duration of CRT on overall survival (OS) were analyzed.

Results

Median duration of CRT was 156 days in group 1 and 195 days in group 2 (p < 0.001). Median progression-free survival and OS were 11.6 (95% confidence interval (CI) 10–13.2) and 14.9 (95% CI 11.7–17.6) months with no difference between the groups. The 2- and 3-year survival rates were 37.9 ± 6.9% and 22.7 ± 6.3% in group 1 and 22.4 ± 4.9% and 15.2 ± 4.3% in group 2, respectively. Duration of CRT was only treatment-related factor predicting OS in the uni- (p < 0.014) and multivariate (p < 0.025) analyses. Short dose-dense CRT was associated with improved OS.

Conclusion

Duration of CRT affects OS in LD SCLC patients with poor initial performance status who successfully completed multimodality treatment.
Literatur
1.
Zurück zum Zitat Auperin A, Arriagada R, Pignon JP et al (1999) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic cranial irradiation overview collaborative group. N Engl J Med 12:476–484CrossRef Auperin A, Arriagada R, Pignon JP et al (1999) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic cranial irradiation overview collaborative group. N Engl J Med 12:476–484CrossRef
2.
Zurück zum Zitat Chen J, Jiang R, Garces Y et al (2010) Prognostic factors for limited-stage small cell lung cancer: a study of 284 patients. Lung Cancer 67:221–226PubMedCrossRef Chen J, Jiang R, Garces Y et al (2010) Prognostic factors for limited-stage small cell lung cancer: a study of 284 patients. Lung Cancer 67:221–226PubMedCrossRef
3.
Zurück zum Zitat De Ruysscher D, Pijls-Johannesma M, Vansteenkiste J et al (2006) Systematic review and meta-analysis of randomized, controlled trials of the timing of chest radiotherapy in patients with limited-stage, small-cell lung cancer. Ann Oncol 17:543–552CrossRef De Ruysscher D, Pijls-Johannesma M, Vansteenkiste J et al (2006) Systematic review and meta-analysis of randomized, controlled trials of the timing of chest radiotherapy in patients with limited-stage, small-cell lung cancer. Ann Oncol 17:543–552CrossRef
4.
Zurück zum Zitat De Ruysscher D, Pijls-Johannesma M, Bentzen SM et al (2006) Time between the first day of chemotherapy and last day of chest radiation is the most important predictor of survival in limited-disease small-cell lung cancer. J Clin Oncol 24:1057–1063CrossRef De Ruysscher D, Pijls-Johannesma M, Bentzen SM et al (2006) Time between the first day of chemotherapy and last day of chest radiation is the most important predictor of survival in limited-disease small-cell lung cancer. J Clin Oncol 24:1057–1063CrossRef
5.
Zurück zum Zitat Fietkau R, Sauer R (2002) Die frühzeitige Radiotherapie im Rahmen der radiochemotherapie des kleinzelligen Bronchialkarzinoms ist im Stadium “Limited Disease” der späten Bestrahlung überlegen. Strahlenther Onkol 178:585–588PubMed Fietkau R, Sauer R (2002) Die frühzeitige Radiotherapie im Rahmen der radiochemotherapie des kleinzelligen Bronchialkarzinoms ist im Stadium “Limited Disease” der späten Bestrahlung überlegen. Strahlenther Onkol 178:585–588PubMed
6.
Zurück zum Zitat Fried DB, Morris DE, Poole C et al (2004) Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol 22:4837–4845PubMedCrossRef Fried DB, Morris DE, Poole C et al (2004) Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol 22:4837–4845PubMedCrossRef
7.
Zurück zum Zitat Früh M, Kacsir B, Ess S et al (2011) Extrapulmonary small cell carcinoma: an indication for prophylactic cranial irradiation? A single center experience. Strahlenther Onkol 187:561–567PubMedCrossRef Früh M, Kacsir B, Ess S et al (2011) Extrapulmonary small cell carcinoma: an indication for prophylactic cranial irradiation? A single center experience. Strahlenther Onkol 187:561–567PubMedCrossRef
8.
Zurück zum Zitat Gregor A, Drings P, Rinaldi M et al (1995) Acute toxicity of alternating schedule of chemotherapy and irradiation in limited small-cell lung cancer in a pilot study (08877) of the EORTC Lung Cancer Cooperative Group. Ann Oncol 6:403–405 (letter)PubMed Gregor A, Drings P, Rinaldi M et al (1995) Acute toxicity of alternating schedule of chemotherapy and irradiation in limited small-cell lung cancer in a pilot study (08877) of the EORTC Lung Cancer Cooperative Group. Ann Oncol 6:403–405 (letter)PubMed
9.
Zurück zum Zitat Gregor A, Drings P, Burghouts J et al (1997) Randomized trial of alternating versus sequential radiotherapy/chemotherapy in limited-disease patients with small-cell lung cancer: a European Organisation for Research and Treatment of Cancer Lung Cancer Cooperative Group study. J Clin Oncol 15:2840–2847PubMed Gregor A, Drings P, Burghouts J et al (1997) Randomized trial of alternating versus sequential radiotherapy/chemotherapy in limited-disease patients with small-cell lung cancer: a European Organisation for Research and Treatment of Cancer Lung Cancer Cooperative Group study. J Clin Oncol 15:2840–2847PubMed
10.
Zurück zum Zitat Ichinose Y, Hara N, Ohta M et al (1989) Brain metastases in patients with limited small cell lung cancer achieving complete remission. Correlation with TNM Staging. Chest 96:1332–1335PubMedCrossRef Ichinose Y, Hara N, Ohta M et al (1989) Brain metastases in patients with limited small cell lung cancer achieving complete remission. Correlation with TNM Staging. Chest 96:1332–1335PubMedCrossRef
11.
Zurück zum Zitat Jeremic B, Shibamoto Y, Acimovic L, Milisavljevic S (1997) Initial versus delayed accelerated hyperfractionated radiation therapy and concurrent chemotherapy in limited small cell lung cancer. J Clin Oncol 15:893–900PubMed Jeremic B, Shibamoto Y, Acimovic L, Milisavljevic S (1997) Initial versus delayed accelerated hyperfractionated radiation therapy and concurrent chemotherapy in limited small cell lung cancer. J Clin Oncol 15:893–900PubMed
12.
Zurück zum Zitat Klautke G, Sauer R, Fietkau R (2008) Combined treatment modality in small cell lung cancer. The impact of radiotherapy on survival. Strahlenther Onkol 184:61–66PubMedCrossRef Klautke G, Sauer R, Fietkau R (2008) Combined treatment modality in small cell lung cancer. The impact of radiotherapy on survival. Strahlenther Onkol 184:61–66PubMedCrossRef
13.
Zurück zum Zitat Klautke G, Fahndrich S, Semrau S et al (2006) Simultaneous chemoradiotherapy with irinotecan and cisplatin in limited disease small cell lung cancer: a phase I study. Lung Cancer 53:183–188PubMedCrossRef Klautke G, Fahndrich S, Semrau S et al (2006) Simultaneous chemoradiotherapy with irinotecan and cisplatin in limited disease small cell lung cancer: a phase I study. Lung Cancer 53:183–188PubMedCrossRef
14.
Zurück zum Zitat Manapov F, Klautke G, Fietkau R (2008) Prevalence of brain metastases immediately before prophylactic cranial irradiation in limited disease small cell lung cancer patients with complete remission to chemoradiotherapy: a single institution experience. J Thorac Oncol 3:652–655PubMedCrossRef Manapov F, Klautke G, Fietkau R (2008) Prevalence of brain metastases immediately before prophylactic cranial irradiation in limited disease small cell lung cancer patients with complete remission to chemoradiotherapy: a single institution experience. J Thorac Oncol 3:652–655PubMedCrossRef
15.
Zurück zum Zitat Manapov F (2009) Central nervous system relapse continues to be a therapeutic challenge in extensive disease small-cell lung cancer patients with initial symptomatic brain metastases and good response to chemoradiotherapy. J Neurooncol 98:349–355PubMedCrossRef Manapov F (2009) Central nervous system relapse continues to be a therapeutic challenge in extensive disease small-cell lung cancer patients with initial symptomatic brain metastases and good response to chemoradiotherapy. J Neurooncol 98:349–355PubMedCrossRef
16.
Zurück zum Zitat Matsumoto Y, Mari S, Makoto S et al (2003) Chemoradiotherapy for limited disease small cell lung cancer. Niigata Kenritsu Byoin Iggakkaishi 51:6–13 Matsumoto Y, Mari S, Makoto S et al (2003) Chemoradiotherapy for limited disease small cell lung cancer. Niigata Kenritsu Byoin Iggakkaishi 51:6–13
17.
Zurück zum Zitat Miller KL, Marks LB, Sibley GS et al (2003) Routine use of approximately 60 Gy once- daily thoracic irradiation for patients with limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys 56:355–359PubMedCrossRef Miller KL, Marks LB, Sibley GS et al (2003) Routine use of approximately 60 Gy once- daily thoracic irradiation for patients with limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys 56:355–359PubMedCrossRef
18.
Zurück zum Zitat Movsas B, Moughan J, Komaki R et al (2003) Radiotherapy patterns of care study in lung carcinoma. J Clin Oncol 21:4553–4559PubMedCrossRef Movsas B, Moughan J, Komaki R et al (2003) Radiotherapy patterns of care study in lung carcinoma. J Clin Oncol 21:4553–4559PubMedCrossRef
19.
Zurück zum Zitat Murray N, Coy P, Pater JL et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited stage small-cell lung cancer. J Clin Oncol 11:336–344PubMed Murray N, Coy P, Pater JL et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited stage small-cell lung cancer. J Clin Oncol 11:336–344PubMed
20.
Zurück zum Zitat Pignon JP, Ariagada R, Ihde DC et al (1992) A meta-analysis of thoracic radiotherapy for small cell lung cancer. N Engl J Med 327:1618–1624PubMedCrossRef Pignon JP, Ariagada R, Ihde DC et al (1992) A meta-analysis of thoracic radiotherapy for small cell lung cancer. N Engl J Med 327:1618–1624PubMedCrossRef
21.
Zurück zum Zitat Pijls -Johannesma MCG, De Ruysscher D, Lambin P et al (2004) Early versus late chest radiotherapy for limited stage small-cell lung cancer. Cochrane Database Syst Rev:CD004700 Pijls -Johannesma MCG, De Ruysscher D, Lambin P et al (2004) Early versus late chest radiotherapy for limited stage small-cell lung cancer. Cochrane Database Syst Rev:CD004700
22.
Zurück zum Zitat Rades D, Nadrowitz R, Buchmann I et al (2010) Radiolabeled cetuximab plus whole-brain irradiation (WBI) for the treatment of brain metastases from non-small cell lung cancer (NSCLC). Strahlenther Onkol 186:458–462PubMedCrossRef Rades D, Nadrowitz R, Buchmann I et al (2010) Radiolabeled cetuximab plus whole-brain irradiation (WBI) for the treatment of brain metastases from non-small cell lung cancer (NSCLC). Strahlenther Onkol 186:458–462PubMedCrossRef
23.
Zurück zum Zitat Roeder F, Friedrich J, Timke C et al (2010) Correlation of patient-related factors and dose-volume histogramm parameters with the onset of radiation pneumonitis in patients with small cell lung cancer. Strahlenther Onkol 186:149–156PubMedCrossRef Roeder F, Friedrich J, Timke C et al (2010) Correlation of patient-related factors and dose-volume histogramm parameters with the onset of radiation pneumonitis in patients with small cell lung cancer. Strahlenther Onkol 186:149–156PubMedCrossRef
24.
Zurück zum Zitat Sas-Korczyńska B, Korzeniowski S, Wójcik E (2010) Comparison of the effectiveness of “late” and “early” prophylactic cranial irradiation in patients with limited-stage small cell lung cancer. Strahlenther Onkol 186:315–319PubMedCrossRef Sas-Korczyńska B, Korzeniowski S, Wójcik E (2010) Comparison of the effectiveness of “late” and “early” prophylactic cranial irradiation in patients with limited-stage small cell lung cancer. Strahlenther Onkol 186:315–319PubMedCrossRef
25.
Zurück zum Zitat Schnabel T, Schmitt G (1993) The role of radiotherapy in the management of small cell lung cancer (SCLC). Strahlenther Onkol 169:329–338PubMed Schnabel T, Schmitt G (1993) The role of radiotherapy in the management of small cell lung cancer (SCLC). Strahlenther Onkol 169:329–338PubMed
26.
Zurück zum Zitat Seute T, Leffers P, Wilmink JT et al (2006) Response of asymptomatic brain metastases from small-cell lung cancer to systemic first -line chemotherapy. J Clin Oncol 24:2079–2083PubMedCrossRef Seute T, Leffers P, Wilmink JT et al (2006) Response of asymptomatic brain metastases from small-cell lung cancer to systemic first -line chemotherapy. J Clin Oncol 24:2079–2083PubMedCrossRef
27.
Zurück zum Zitat Skarlos DV, Samantas E, Briassoulis E et al (2001) Randomized comparison of early versus late hyperfractionated thoracic irradiation concurrently with chemotherapy in limited disease small-cell lung cancer: a randomized phase II study of the Hellenic Cooperative Oncology Group (HeCOG). Ann Oncol 12:1231–1238PubMedCrossRef Skarlos DV, Samantas E, Briassoulis E et al (2001) Randomized comparison of early versus late hyperfractionated thoracic irradiation concurrently with chemotherapy in limited disease small-cell lung cancer: a randomized phase II study of the Hellenic Cooperative Oncology Group (HeCOG). Ann Oncol 12:1231–1238PubMedCrossRef
28.
Zurück zum Zitat Spiro SG, James LE, Rudd RM et al (2006) Early compared with late radiotherapy in combined modality treatment for limited disease cancer: a London Lung Cancer Group multicenter randomized clinical trial and meta-analysis. J Clin Oncol 24:3823–3829PubMedCrossRef Spiro SG, James LE, Rudd RM et al (2006) Early compared with late radiotherapy in combined modality treatment for limited disease cancer: a London Lung Cancer Group multicenter randomized clinical trial and meta-analysis. J Clin Oncol 24:3823–3829PubMedCrossRef
29.
Zurück zum Zitat Takada M, Fukuoka M, Kawahara M et al (2002) Phase III study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104. J Clin Oncol 20:3054–3060PubMedCrossRef Takada M, Fukuoka M, Kawahara M et al (2002) Phase III study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104. J Clin Oncol 20:3054–3060PubMedCrossRef
30.
Zurück zum Zitat Tomita N, Kodaira T, Hida T et al (2010) The impact of radiation dose and fractionation on outcomes for limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys 76:1121–1126PubMedCrossRef Tomita N, Kodaira T, Hida T et al (2010) The impact of radiation dose and fractionation on outcomes for limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys 76:1121–1126PubMedCrossRef
31.
Zurück zum Zitat Turrisi AT 3rd, Kim K, Blum R et al (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 340:265–271PubMedCrossRef Turrisi AT 3rd, Kim K, Blum R et al (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 340:265–271PubMedCrossRef
32.
Zurück zum Zitat Videtic GM, Truong PT, Ash RB et al (2005) Does sex influence the impact that smoking, treatment interruption and impaired pulmonary function have on outcomes in limited stage small cell lung cancer treatment? Can Respir J 12:245–250PubMed Videtic GM, Truong PT, Ash RB et al (2005) Does sex influence the impact that smoking, treatment interruption and impaired pulmonary function have on outcomes in limited stage small cell lung cancer treatment? Can Respir J 12:245–250PubMed
33.
Zurück zum Zitat Warde P, Payne D (1992) Does thoracic irradiation improve survival and local control in limited stage small cell carcinoma of the lung? A meta-analysis. J Clin Oncol 10:890–895PubMed Warde P, Payne D (1992) Does thoracic irradiation improve survival and local control in limited stage small cell carcinoma of the lung? A meta-analysis. J Clin Oncol 10:890–895PubMed
34.
Zurück zum Zitat Work E, Nielsen OS, Bentzen SM et al (1997) Randomized study of initial versus late chest irradiation combined with chemotherapy in limited-stage small-cell lung cancer. J Clin Oncol 15:3030–3037PubMed Work E, Nielsen OS, Bentzen SM et al (1997) Randomized study of initial versus late chest irradiation combined with chemotherapy in limited-stage small-cell lung cancer. J Clin Oncol 15:3030–3037PubMed
Metadaten
Titel
Chemoradiotherapy duration correlates with overall survival in limited disease SCLC patients with poor initial performance status who successfully completed multimodality treatment
verfasst von
F. Manapov
S. Klöcking
M Niyazi
C. Belka
G. Hildebrandt
R. Fietkau
G. Klautke
Publikationsdatum
01.01.2012
Verlag
Urban and Vogel
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 1/2012
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-011-0016-9

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