Concurrent Chemoradiotherapy with Original Chemotherapy Regimens may not be Suitable for Patients Who Failed to Respond to Induction Chemotherapy in Limited-stage Small Cell Lung Cancer
10.3779/j.issn.1009-3419.2016.12.11
- VernacularTitle:诱导化疗无效的局限期小细胞肺癌可能不宜原方案同期放化疗
- Author:
WANG DAQUAN
1
;
XU LIMING
;
ZHAO LUJUN
;
ZHANG WENCHENG
;
PANG QINGSONG
;
LIU NINGBO
;
CHEN XI
;
CHEN XIULI
;
YUAN ZHIYONG
;
WANG PING
Author Information
1. 300060天津，天津医科大学肿瘤医院放疗科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室
- Keywords:
Lung neoplasms;
Induction chemotherapy;
Concurrent chemoradiotherapy;
Second-line regimens;
Prognosis
- From:
Chinese Journal of Lung Cancer
2016;19(12):871-879
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective The group of small cell lung cancer (SCLC) are usually highly sensitive to chemotherapy, and less than 15% of them are resistant to drugs. We respectively evaluate the correlation of the sequence and timing of radiotherapy with progression-free survival (PFS) and overall survival (OS) in patients with limited-stage SCLC (LS-SCLC), and to ifgure out whether concurrent chemoradiotherapy is superior to sequent chemoradiotherapy.Methods Sixty-seven patients diagnosed with LS-SCLC from January 2009 to June 2014 failed to respond to induction chemotherapy. According to the sequence of therapy, they were divided into concurrent chemoradiotherapy group (n=32) and sequent chemoradiotherapy group (n=35). Ninety-four percent of the patients were diagnosed with stage III, and six percent were stage Ib-IIb. Twenty-ifve patients were treated with prophylactic cranial irradiation (PCI). hTeKaplan-Meier method was used to calculate survival time andLog-rank test was used for between-group comparisons. Between-group comparison of categorical data was made byχ2 test.Results In all patients, the 2-year OS, PFS and LC rates were 53.7%, 20.9% and 58.2%. hTe 2-year OS and PFS rates of concurrent chemoradiotherapy group and sequent chemoradiotherapy were 37.5%vs 54.3% (P=0.048) and 12.5%vs 28.6% (P=0.149). Hematologic toxicities were more common in concurrent group than sequent one (P=0.031), and no statistical difference was observed between the two groups in terms of grade 3 radiation esophagitis, pneumonitis and gas-trointestinal reactions (9.4%vs 0,P=0.176; 12.5%vs 2.9%,P=0.318; 12.5%vs 2.9%,P=0.109). Patients treated with PCI have superior OS and PFS comparing with those not (56.0%vs 38.1%,P=0.029; 24%vs 19%,P=0.012).Conclusion Concurrent chemoradiotherapy with original chemotherapy regimens may not be suitable for patients who failed to respond to induction chemotherapy in LS-SCLC, and second-line regimens or radiotherapy alone can be used for them, but prospective trils with large sample are still needed to conifrm that.
