Sequential or concomitant chemotherapy in limited stage small-cell lung cancer.

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Ressource 1Télécharger: BIB_965E5B4C2B4A.P001.pdf (430.05 [Ko])
Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_965E5B4C2B4A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Sequential or concomitant chemotherapy in limited stage small-cell lung cancer.
Périodique
Swiss Medical Weekly
Auteur(s)
Khanfir K., Elhfidh M., Anchisi S., Matzinger O., Bieri S., Mirimanoff R.O., Ozsahin M., Zouhair A.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
2011
Volume
141
Pages
w13205
Langue
anglais
Résumé
PURPOSE: Chemotherapy (CT) combined with radiation therapy (RT) is the standard treatment for limited disease small-cell lung cancer (LDSCLC). Many questions including RT dose, fractionation, and sequence of RT/CT administration remain controversial. In this paper, we retrospectively assessed the outcome of patients with LDSCLC treated with radiation of at least 50 Gy.METHODS AND MATERIALS: From December 1997 to January 2006, 69 consecutive patients with LDSCLC were treated at our institutions. Treatment consisted of at least 4 cycles of CT, and 3D conformal thoracic RT. The median age was 61 years (range, 37-78 years). Sequential or concomitant CT/RT was given in 47 (68%) and 22 (32%) of the patients, respectively. The median RT dose was 60 Gy. Prophylactic cranial irradiation (PCI) was administered in 47 (68%) patients.RESULTS: With a median follow-up of 36 months (range, 6-107), 16 patients were alive without disease. The median overall survival time was 24 months, with a 3-year survival rate of 29%. The 3-year disease-free survival (DFS) and loco-regional control (LRC) rates were 23% and 60%, respectively. A better DFS was significantly associated with performance status (PS) 0 (p = 0.004), complete response to treatment (p = 0.03), and PCI group (p = 0.03). A trend towards improved overall survival (OS) was observed for patients who underwent PCI (p = 0.07). Patients treated with sequential CT/RT had a better outcome than those treated with concomitant treatment (3-year DFS rate 27% vs. 13%; p = 0.04). However, PCI was delivered more frequently for the sequential group. No significant dose-response relationship was found in terms of LRC. The multivariate analysis showed that complete response to treatment was the only significant factor for OS.CONCLUSION: Complete response to treatment was the most important factor for OS. A better DFS was significantly associated with the PCI group. We did not find a significant difference in outcome between patients receiving doses of 60 Gy or more and patients receiving 60 Gy or less.
Pubmed
Web of science
Open Access
Oui
Création de la notice
04/07/2011 11:52
Dernière modification de la notice
20/08/2019 14:58
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