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Published in: Lung 3/2017

01-06-2017 | Lung Cancer

Impact of Radiation Therapy in Surgically Resected Limited-Stage Small Cell Lung Carcinoma

Authors: Samuel K. Kim, Julia Manzerova, Paul Christos, A. Gabriella Wernicke, Bhupesh Parashar

Published in: Lung | Issue 3/2017

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Abstract

Purpose

To elucidate the role of radiation therapy (RT) in the treatment of surgically resected limited-stage small cell lung carcinoma (LSCLC).

Methods

We queried the SEER database from 1998 to 2012 to identify patients who were diagnosed with LSCLC as their only primary tumor. Kaplan–Meier analysis was utilized to determine disease-specific survival (DSS) and overall survival (OS), while multivariate analysis was used to compare survival in terms of patients and treatment characteristics.

Results

Eight hundred twenty-three LSCLC patients were identified for inclusion within the study. 12-month DSS for patients who did not receive surgery or RT was 31.9% (95% CI 27.7–36.3), 93.3% (95% CI 71.6–90.5) for surgery alone, and 81.0% (95% CI 69.3–88.6) for surgery + RT. 12-month OS was 27.2% (95% CI 23.4–31.1), 74.7% (95% CI 62.6–83.4), and 78.3% (95% CI 66.4–86.4) for no surgery or RT, for surgery alone, and for surgery + RT, respectively. In terms of multivariate analysis, patients receiving surgery alone and patients receiving surgery + RT had a better DSS and OS than those who received neither treatment. However, OS (HR 1.60; 95% CI 0.93–2.75, p = 0.09) and DSS (HR 1.34; 95% CI 0.72–2.51, p = 0.37) were not significantly associated with patients receiving surgery alone compared to surgery + RT.

Conclusions

Surgery alone and surgery + RT were positively associated with DSS and OS compared to patients who did not receive surgery or RT. However, the addition of RT to surgery did not significantly predict DSS or OS compared to surgery alone.
Literature
1.
go back to reference American Cancer Society (2015) Cancer Facts & Figures 2015. American Cancer Society, Atlanta American Cancer Society (2015) Cancer Facts & Figures 2015. American Cancer Society, Atlanta
2.
go back to reference Chute JP et al (1997) Outcome of patients with small-cell lung cancer during 20 years of clinical research at the US National Cancer Institute. Mayo Clin Proc 72(10):901–912CrossRefPubMed Chute JP et al (1997) Outcome of patients with small-cell lung cancer during 20 years of clinical research at the US National Cancer Institute. Mayo Clin Proc 72(10):901–912CrossRefPubMed
3.
go back to reference Micke P et al (2002) Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer—what limits limited disease? Lung Cancer 37(3):271–276CrossRefPubMed Micke P et al (2002) Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer—what limits limited disease? Lung Cancer 37(3):271–276CrossRefPubMed
4.
go back to reference Johnson BE et al (2006) Small cell lung cancer clinical practice guidelines in oncology. J Natl Compr Cancer Netw 4(6):602–622CrossRef Johnson BE et al (2006) Small cell lung cancer clinical practice guidelines in oncology. J Natl Compr Cancer Netw 4(6):602–622CrossRef
5.
go back to reference Ploenes T et al (2012) Surgical treatment of early stage small cell lung cancer. Asian Cardiovasc Thorac Ann 20(6):694–698CrossRefPubMed Ploenes T et al (2012) Surgical treatment of early stage small cell lung cancer. Asian Cardiovasc Thorac Ann 20(6):694–698CrossRefPubMed
6.
go back to reference Clemente M et al (2013) The role of surgery in early stage small cell lung cancer: should it be re-evaluated? Rev Med Suisse 9(407):2170, 2172–2174 Clemente M et al (2013) The role of surgery in early stage small cell lung cancer: should it be re-evaluated? Rev Med Suisse 9(407):2170, 2172–2174
7.
go back to reference Schneider BJ, Saxena A, Downey RJ (2011) Surgery for early-stage small cell lung cancer. J Natl Compr Cancer Netw 9(10):1132–1139CrossRef Schneider BJ, Saxena A, Downey RJ (2011) Surgery for early-stage small cell lung cancer. J Natl Compr Cancer Netw 9(10):1132–1139CrossRef
8.
go back to reference Fox W, Scadding JG (1973) Medical Research Council comparative trial of surgery and radiotherapy for primary treatment of small-celled or oat-celled carcinoma of bronchus. Ten-year follow-up. Lancet 2(7820):63–65CrossRefPubMed Fox W, Scadding JG (1973) Medical Research Council comparative trial of surgery and radiotherapy for primary treatment of small-celled or oat-celled carcinoma of bronchus. Ten-year follow-up. Lancet 2(7820):63–65CrossRefPubMed
9.
go back to reference Lad T et al (1994) A prospective randomized trial to determine the benefit of surgical resection of residual disease following response of small cell lung cancer to combination chemotherapy. Chest 106(6 Suppl): 320s–323sCrossRefPubMed Lad T et al (1994) A prospective randomized trial to determine the benefit of surgical resection of residual disease following response of small cell lung cancer to combination chemotherapy. Chest 106(6 Suppl): 320s–323sCrossRefPubMed
10.
go back to reference Takei H et al (2014) Surgery for small cell lung cancer: a retrospective analysis of 243 patients from Japanese Lung Cancer Registry in 2004. J Thorac Oncol 9(8):1140–1145CrossRefPubMed Takei H et al (2014) Surgery for small cell lung cancer: a retrospective analysis of 243 patients from Japanese Lung Cancer Registry in 2004. J Thorac Oncol 9(8):1140–1145CrossRefPubMed
11.
go back to reference Weksler B et al (2012) Surgical resection should be considered for stage I and II small cell carcinoma of the lung. Ann Thorac Surg 94(3):889–893CrossRefPubMed Weksler B et al (2012) Surgical resection should be considered for stage I and II small cell carcinoma of the lung. Ann Thorac Surg 94(3):889–893CrossRefPubMed
12.
go back to reference Stish BJ et al (2015) Long-term outcomes and patterns of failure after surgical resection of small-cell lung cancer. Clin Lung Cancer 16:e67–e73CrossRefPubMed Stish BJ et al (2015) Long-term outcomes and patterns of failure after surgical resection of small-cell lung cancer. Clin Lung Cancer 16:e67–e73CrossRefPubMed
13.
go back to reference 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(6):890–895CrossRefPubMed 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(6):890–895CrossRefPubMed
14.
go back to reference Pignon JP et al (1992) A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med 327(23):1618–1624CrossRefPubMed Pignon JP et al (1992) A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med 327(23):1618–1624CrossRefPubMed
15.
go back to reference Perry MC et al (1998) Thoracic radiation therapy added to chemotherapy for small-cell lung cancer: an update of Cancer and Leukemia Group B Study 8083. J Clin Oncol 16(7):2466–2467CrossRefPubMed Perry MC et al (1998) Thoracic radiation therapy added to chemotherapy for small-cell lung cancer: an update of Cancer and Leukemia Group B Study 8083. J Clin Oncol 16(7):2466–2467CrossRefPubMed
16.
go back to reference Murray N et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 11(2):336–344CrossRefPubMed Murray N et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 11(2):336–344CrossRefPubMed
17.
go back to reference Takada 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(14):3054–3060CrossRefPubMed Takada 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(14):3054–3060CrossRefPubMed
18.
go back to reference Eskandar A et al (2015) Racial and sex differences in presentation and outcomes of small cell lung cancer in the United States: 1973 to 2010. Chest 147(4):e164–e165CrossRefPubMedPubMedCentral Eskandar A et al (2015) Racial and sex differences in presentation and outcomes of small cell lung cancer in the United States: 1973 to 2010. Chest 147(4):e164–e165CrossRefPubMedPubMedCentral
19.
go back to reference Foster NR et al (2009) Prognostic factors differ by tumor stage for small cell lung cancer: a pooled analysis of North Central Cancer Treatment Group trials. Cancer 115(12):2721–2731CrossRefPubMedPubMedCentral Foster NR et al (2009) Prognostic factors differ by tumor stage for small cell lung cancer: a pooled analysis of North Central Cancer Treatment Group trials. Cancer 115(12):2721–2731CrossRefPubMedPubMedCentral
20.
go back to reference Sculier JP et al (2008) The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th edition of the TNM classification of malignant tumors and the proposals for the 7th edition. J Thorac Oncol 3(5):457–466CrossRefPubMed Sculier JP et al (2008) The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th edition of the TNM classification of malignant tumors and the proposals for the 7th edition. J Thorac Oncol 3(5):457–466CrossRefPubMed
Metadata
Title
Impact of Radiation Therapy in Surgically Resected Limited-Stage Small Cell Lung Carcinoma
Authors
Samuel K. Kim
Julia Manzerova
Paul Christos
A. Gabriella Wernicke
Bhupesh Parashar
Publication date
01-06-2017
Publisher
Springer US
Published in
Lung / Issue 3/2017
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-017-9992-6

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