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Open Access 01-12-2016 | Research article

Evaluation of the role of remission status in a heterogeneous limited disease small-cell lung cancer patient cohort treated with definitive chemoradiotherapy

Authors: Farkhad Manapov, Maximilian Niyazi, Sabine Gerum, Olarn Roengvoraphoj, Chukwuka Eze, Minglun Li, Guido Hildebrandt, Rainer Fietkau, Gunther Klautke, Claus Belka

Published in: BMC Cancer | Issue 1/2016

Abstract

Background

The role of remission status in limited disease (LD) small-cell lung cancer (SCLC) patients treated with definitive chemoradiotherapy (CRT) remains to be finally clarified.

Methods

Individual data from 184 patients treated with definitive CRT concurrently or sequentially were retrospectively reviewed. Kaplan-Meier analysis as well as univariate and multivariate Cox regression models were used to describe survival within patient subgroups defined by remission status.

Results

71 (39 %) patients were treated in the concurrent, 113 (61 %) in the sequential CRT mode. Prophylactic cranial irradiation (PCI) was applied in 71 (39 %) patients. 37 (20 %) patients developed local, while 89 (48 %) distant recurrence. 58 (32 %) patients developed metachronous brain metastases. Complete, partial remission and non-response (defined as stable and progressive disease) were documented in 65 (35 %), 77 (42 %), and 37 (20 %) patients, respectively. In complete responders median overall survival was 21.8 months (95CI: 18.6 – 25) versus 14.9 (95 % CI: 11.7 – 18.2) (p = 0.041, log-rank test) and 11.5 months (95 % CI: 8.9 – 15.0) (p < 0.001, log-rank test) in partial and non-responders, respectively. The same effect was documented for the time to progression and distant metastasis-free survival. In the multivariate analysis achievement of complete remission as a variable shows a trend for the prolonged time to progression (p = 0.1, HR 1.48) and distant metastasis-free survival (p = 0.06, HR 1.63) compared to partial responders and was highly significant compared to non-responders.

Conclusion

In this treated heterogeneous LD SCLC patient cohort complete remission was associated with longer time to progression, distant metastasis-free and overall survival compared to the non- and especially partial responders.

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Title: Evaluation of the role of remission status in a heterogeneous limited disease small-cell lung cancer patient cohort treated with definitive chemoradiotherapy
Authors: Farkhad Manapov
Maximilian Niyazi
Sabine Gerum
Olarn Roengvoraphoj
Chukwuka Eze
Minglun Li
Guido Hildebrandt
Rainer Fietkau
Gunther Klautke
Claus Belka
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-016-2245-x

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