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Chemotherapy with concurrent brain and thoracic radiotherapy in brain-only metastases of treatment naive small-cell lung cancer: a phase II study

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Abstract

To study the treatment outcomes of brain-only metastases from small-cell lung cancer (SCLC) at initial diagnose treated by chemotherapy with concurrent brain and thoracic radiotherapy (RT). From Jan 2004 to Jan 2009, 36 treatment-naïve SCLC patients with brain-only metastases in Sun yat-sen University were enrolled. Treatment contained initial EP chemotherapy with concurrent whole-brain radiotherapy (WBRT). EP regimen consisted of etoposide 100 mg/m2 IV d1-3, cisplatin 80 mg/m2 IV d1, repeated every 3 weeks. WBRT with total dose of 30 Gy in 10 fractions was started within 1 week from the beginning of chemotherapy followed by thoracic RT including 2 Gy once daily to a total dose of 60 Gy. Treatment responses were evaluated after 3 cycles of chemotherapy. EP regimen was given totally 6 cycles for no tumor progression. Thirty-four patients were evaluable. All of the 20 CNS symptomatic patients experienced symptoms relief. Objective responses in the brain and primary thoracic lesions were observed in 26 (76.5%, 16CR + 10PR) and 29 (85.3%, 23CR + 6PR) patients, respectively. The median survival time (MST) was 19.2 months, and the 1-and 2-year overall survival rates (OS) were 70.6 and 29.4%, respectively, in all patients. Patients with CR response had the longest MST of 21.9 months and 1-and 2-year OS of 93.8 and 43.8%, respectively. Treatment toxicity profiles were acceptable. The treatment strategy of concurrent chemotherapy with brain and thoracic RT might achieve promising survival outcomes comparable to limited-stage SCLC in initially diagnosed SCLC with brain-only metastases.

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References

  1. Pedersen AG. Diagnosis of CNS-metastases from SCLC. In: Hansen HH, editor. Lung cancer: basic and clinical aspects. Dordrecht: Martinus Nijhoff; 1986. p. 153–82.

    Chapter  Google Scholar 

  2. Bunn PA, Nugent JL, Matthews M. Central nervous system metastases in small cell bronchogenic carcinoma. Semin Oncol. 1978;5:314–22.

    PubMed  Google Scholar 

  3. Seute T, Leffers P, ten Velde GP, et al. Neurologic disorders in 432 consecutive patients with small cell lung carcinoma. Cancer. 2004;100:801–6.

    Article  PubMed  Google Scholar 

  4. Postmus PE. Brain metastases from small cell lung cancer: Chemotherapy, radiotherapy, or both? Semin Radiat Oncol. 1995;5:69–73.

    Article  PubMed  Google Scholar 

  5. Bohlen G, Meyners T, Kieckebusch S, et al. Short-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC). Clin Neurol Neurosurg. 2010;112:183–7.

    Article  PubMed  Google Scholar 

  6. Lee JS, Murphy WK, Glisson BS, et al. Primary chemotherapy of brain metastasis in small-cell lung cancer. J Clin Oncol. 1989;7:916–22.

    PubMed  CAS  Google Scholar 

  7. Seute T, Leffers P, Wilmink JT, et al. Response of asymptomatic brain metastases from small-cell lung cancer to systemic first-line chemotherapy. J Clin Oncol. 2006;24:2079–83.

    Article  PubMed  CAS  Google Scholar 

  8. Korfel A, Oehm C, Von J, et al. Response to topotecan of symptomatic brain metastases of small-cell lung cancer also after whole-brain irradiation: a multicentre phase II study. Eu J Cancer. 2002;38:1724–9.

    Article  CAS  Google Scholar 

  9. Veslemes M, Polyzos A, Latsi P, et al. Outcome of patients with brain metastases after combined modality therapy in small cell lung cancer (SCLC): a retrospective study. J Chemother. 1995;7:460–2.

    PubMed  CAS  Google Scholar 

  10. Yue X, Zang QC. Sequential treatment of VmP regimen and whole brain radiotherapy for small cell lung cancer patients with brain metastases. Ai Zheng. 2004;23(12):1671–6.

    PubMed  Google Scholar 

  11. Postmus PE, Smit EF, Haaxma-Reiche H. Treatment of central nervous system metastases from small cell lung cancer with chemotherapy. Lung Cancer. 1993;9:281–6.

    Article  Google Scholar 

  12. Postmus PE, Haaxma-Reiche H, Smit EF, et al. Whole brain radiotherapy used in addition to teniposide has a higher response rate for cerebral metastasis from small-cell lung cancer but no influence on survival rates compared to teniposide alone. Evidence-based Oncol. 2001;2:105–6.

    Article  Google Scholar 

  13. Liu M, Zhou Y, Han Q, et al. Whole brain radiotherapy concomitant or sequential Vm26/DDP in treating small cell lung cancer patients with brain metastases. Chin-Ger J Clin Oncol Jan. 2010;9(1):17–21.

    Article  CAS  Google Scholar 

  14. Postmus PE, Haaxma-Reiche H, Smit EF, et al. Treatment of brain metastases of small-cell lung cancer: Comparing teniposide and teniposide with whole-brain radiotherapy-A phase III study of the European organization for the research and treatment of cancer lung cancer cooperative group. J Clin Oncol. 2000;18:3400–8.

    PubMed  CAS  Google Scholar 

  15. Grossi F, Scolaro T, Tixi L, et al. The role of systemic chemotherapy in the treatment of brain metastases from small-cell lung cancer. Crit Rev Oncol Hematol. 2001;37:61–7.

    Article  PubMed  CAS  Google Scholar 

  16. Kochhar R, Frytak S, Shaw EG. Survival of patients with extensive small-cell lung cancer who have only brain metastases at initial diagnosis. Am J Clin Oncol. 1997;20(2):125–7.

    Article  PubMed  CAS  Google Scholar 

  17. van Hazel GA, Scott M, Eagan RT. The effect of CNS metastases on the survival of patients with small cell cancer of the lung. Cancer. 1983;51(5):933–7.

    Article  PubMed  Google Scholar 

  18. Postmus PE, Haaxma-Reiche H, Gregor A, et al. Brain-only metastases of small cell lung cancer; efficacy of whole brain radiotherapy. An EORTC phase II study. Radiother Oncol. 1998;46:29–32.

    Article  PubMed  CAS  Google Scholar 

  19. Giannone L, Johnson DH, Hande KR, et al. Favorable prognosis of brain metastases in small cell lung cancer. Ann Intern Med. 1987;106:386–9.

    PubMed  CAS  Google Scholar 

  20. Ihde DC, Makuch RW, Carney DM, et al. Prognostic implications of stage of disease and sites of metastases in patients with small cell carcinoma of the lung treated with intensive combination chemotherapy. Am Rev Respir Dis. 1981;123:500–7.

    PubMed  CAS  Google Scholar 

  21. Schild SE, Bonner JA, Shanahan TG, et al. Long-term results of a phase III trial comparing once-daily radiotherapy with twice-daily radiotherapy in limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2004;59(4):943–51.

    Article  PubMed  Google Scholar 

  22. Turrisi AT III, Kim K, Blum R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med. 1999;340(4):265–71.

    Article  PubMed  CAS  Google Scholar 

  23. Paumier A, Péchoux CL. Radiotherapy in small-cell lung cancer: where should it go? Lung Cancer. 2010;69:133–40.

    Article  PubMed  Google Scholar 

  24. Schwer AL, Gaspar LE. Update in the treatment of brain metastases from lung cancer. Clin Lung Cancer. 2006;8(3):180–6.

    Article  PubMed  CAS  Google Scholar 

  25. Demedts IK, Vermaele KY, van Meerbeeck JP. Treatment of extensive-stage small cell lung carcinoma: current status and future prospects. Eur Respir J. 2010;35:202–5.

    Article  PubMed  CAS  Google Scholar 

  26. Stupp R, Monnerat C, Turrisi AT III, et al. Small cell lung cancer: state of the art and future perspectives. Lung Cancer. 2004;45:105–17.

    Article  PubMed  Google Scholar 

  27. Puglisi M, Dolly S, Faria A, et al. Treatment options for small cell lung cancer -do we have more choice? Br J Cancer. 2010;102:629–38.

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

All the authors (Li-kun Chen, He Huang, Hai Liao, Guo-zhen Liu, Yin-duo Zeng, Xiao-xiao Din Lin, Guang-chuan Xu, Wei-dong Wei) have no conflict of interest.

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guang Zhou, Guang Dong, China

    Li-kun Chen, He Huang, Hai Liao, Yin-duo Zeng, Xiao-xiao Dinglin & Guang-chuan Xu

  2. Department of Radiation Oncology, Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guang Zhou, Guang Dong, China

    Guo-zhen Liu

  3. Department of Thoracic Oncology, Cancer Center, State Key Laboratory of Oncology in South China, Sun Yat-sen University, Dongfeng Road, East, 651#, Guang Zhou, Guang Dong, 510060, People’s Republic of China

    Wei-dong Wei

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  1. Li-kun Chen
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  2. He Huang
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  3. Hai Liao
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  4. Guo-zhen Liu
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  7. Guang-chuan Xu
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Correspondence to Wei-dong Wei.

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Chen, Lk., Huang, H., Liao, H. et al. Chemotherapy with concurrent brain and thoracic radiotherapy in brain-only metastases of treatment naive small-cell lung cancer: a phase II study. Med Oncol 29, 1687–1692 (2012). https://doi.org/10.1007/s12032-011-0040-8

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  • DOI: https://doi.org/10.1007/s12032-011-0040-8

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