scholarly journals Clinical outcomes of extensive-stage small cell lung cancer patients treated with thoracic radiotherapy at different times and fractionations

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jinmin Han ◽  
Chengrui Fu ◽  
Baosheng Li
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Dose Fractionation ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung ◽  
Free Survival ◽  
Hyperfractionated Radiotherapy ◽  
Extensive Stage ◽  
Radiation Time

Abstract Objective The purpose of this study was to assess whether thoracic radiotherapy (TRT) combined with chemotherapy (CHT) showed promising anti-tumour activity in extensive-stage small cell lung cancer (ES-SCLC), to explore practice patterns for the radiation time and dose/fractionation and to identify prognostic factors for patients who would benefit from CHT/TRT. Methods A total of 492 ES-SCLC patients were included from January 2010 to March 2019, 244 of whom received CHT/TRT. Propensity score matching was performed to minimize bias between the CHT/TRT and CHT-alone groups. Patients in the CHT/TRT group were categorized into four subgroups based on the number of induction CHT cycles. For effective dose fractionation calculations, we introduced the time-adjusted biological effective dose (tBED). Categorical variables were analysed with chi-square tests and Fisher’s exact tests. Kaplan–Meier curves were generated to estimate survival rates using the R-project. Multivariate prognostic analysis was performed with Cox proportional hazards models. Results Patients who received CHT/TRT experienced improved overall survival (OS) (18.1 vs 10.8 months), progression-free survival (PFS) (9.3 vs 6.0 months) and local recurrence-free survival (LRFS) (12.0 vs 6.6 months) before matching, with similar results after matching. In the CHT/TRT group, the median LRFS times for the groups based on the radiation time were 12.7, 12.0, 12.0, and 9.0 months, respectively. Early TRT had a tendency to prolong PFS (median 10.6 vs 9.8 vs 9.0 vs 7.7 months, respectively, p = 0.091) but not OS (median 17.6 vs 19.5 vs 17.2 vs 19.0 months, respectively, p = 0.622). Notably, patients who received TRT within 6 cycles of CHT experienced prolonged LRFS (p = 0.001). Regarding the radiation dose, patients in the high-dose group (tBED > 50 Gy) who achieved complete response and partial response (CR and PR) to systemic therapy had relatively short OS (median 27.1 vs 22.7, p = 0.026) and PFS (median 11.4 vs 11.2, p = 0.032), but the abovementioned results were not obtained after the exclusion of patients who received hyperfractionated radiotherapy (all p > 0.05). Conclusion CHT/TRT could improve survival for ES-SCLC patients. TRT performed within 6 cycles of CHT and hyperfractionated radiotherapy (45 Gy in 30 fractions) may be a feasible treatment scheme for ES-SCLC patients.

scholarly journals Clinical Outcomes of Extensive Stage Small Cell Lung Cancer Patients Treated With Thoracic Radiotherapy at Different Timing and Fractionation

2020 ◽  
Author(s):  
Jinmin Han ◽  
Chengrui Fu ◽  
Baosheng Li
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Effective Dose ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Dose Fractionation ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung ◽  
Extensive Stage ◽  
Radiation Time

Abstract Objective: The purpose of this study was to assess whether combined thoracic radiotherapy (TRT) on the basis of chemotherapy (ChT) showed promising anti-tumor activity in extensive-stage small cell lung cancer (ES-SCLC), then to explore practice patterns for radiation time and dose/ fractionation and to identify prognostic factors for patients who would benefit from ChT/TRT.Methods: A total of 492 ES-SCLC patients were included from January 2010 to March 2019, of which 244 patients experienced ChT/TRT. Propensity score matching (PSM) was performed to minimize bias between the ChT/TRT and ChT-alone groups. Patients in ChT/TRT group were categorized into four groups based on the number of induction chemotherapy cycles. For effective dose fractionation calculation, we introduced the time-adjusted biological effective dose(tBED). Categorical variables were analyzed with Chi-square tests and Fisher’s exact tests. Survival rates were computed by the Kaplan-Meier method. Multivariate prognostic analysis was performed with Cox proportional hazard models. Results: Patients who received ChT/TRT were associated with improved OS (18.2 vs 10.8 months), PFS (9.0 vs 6.0 months) and LRFS (12.0 vs 6.0 months) before matching, with similar results after matching. In the ChT/TRT group, the median LRFS times for groups based on radiation time were 12.7, 12.0, 12.7, and 9.0 months, respectively. Earlier TRT had a tendency to prolong PFS (median 10.6 vs 9.8 vs 9.1 vs 7.7 months, respectively, p = 0.1095), as was not seen in OS (median 17.6 vs 19.5 vs 17.2 vs 19.1 months, respectively, p = 0.7224). To note, patients within 6 cycles had better LRFS (p = 0.0006). For radiation dose, patients in high-dose group (tBED>50Gy) had worse OS (median 25.9 vs 22.9, p = 0.0484) and PFS (median 12.1 vs 11.2, p=0.0042) in patients with complete response and partial response (CR and PR) to systemic therapy, but the above-mentioned results were not drawn when the population was confined to those receiving standard fractionation with CR and PR. Conclusion: ChT/TRT could improve survival for ES-SCLC patients. We cautiously recommend that TRT should be performed within 6 cycles and receiving hyperfractionated 45Gy in 30 fractions may be a feasible treatment scheme for ES-SCLC patients.

scholarly journals Clinical Outcomes of Extensive Stage Small Cell Lung Cancer Patients Treated With Thoracic Radiotherapy at different timing and fractionation

2021 ◽  
Author(s):  
Jinmin Han ◽  
Chengrui Fu ◽  
Baosheng Li
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Effective Dose ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Dose Fractionation ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung ◽  
Extensive Stage ◽  
Radiation Time

Abstract Objective: The purpose of this study was to assess whether combined thoracic radiotherapy (TRT) on the basis of chemotherapy (CHT) showed promising anti-tumor activity in extensive-stage small cell lung cancer (ES-SCLC), then to explore practice patterns for radiation time and dose/ fractionation and to identify prognostic factors for patients who would benefit from CHT/TRT.Methods: A total of 492 ES-SCLC patients were included from January 2010 to March 2019, of which 244 patients experienced CHT/TRT. Propensity score matching (PSM) was performed to minimize bias between the CHT/TRT and CHT-alone groups. Patients in CHT/TRT group were categorized into four groups based on the number of induction CHT cycles. For effective dose fractionation calculation, we introduced the time-adjusted biological effective dose(tBED). Categorical variables were analyzed with Chi-square tests and Fisher’s exact tests. Kaplan-Meier curves were performed to estimate survival rates using R-project. Multivariate prognostic analysis was performed with Cox proportional hazard models. Results: Patients who received CHT/TRT were associated with improved OS (18.2 vs 10.8 months), PFS (9.0 vs 6.0 months) and LRFS (12.0 vs 6.0 months) before matching, with similar results after matching. In the CHT/TRT group, the median LRFS times for groups based on radiation time were 12.7, 12.0, 12.7, and 9.0 months, respectively. Earlier TRT had a tendency to prolong PFS (median 10.6 vs 9.8 vs 9.1 vs 7.7 months, respectively, p =0.109), as was not seen in OS (median 17.6 vs 19.5 vs 17.2 vs 19.1 months, respectively, p = 0.722). To note, patients performed TRT within 6 cycles CHT had better LRFS (p<0.001). For radiation dose, patients in the high-dose group (tBED>50Gy) had relatively shorter OS (median 25.9 vs 22.9, p = 0.048) and PFS (median 12.1 vs 11.2, p=0.004) in patients with complete response and partial response (CR and PR) to systemic therapy, but the above-mentioned results were not drawn after the exclusion of patients receiving hyperfractionated radiotherapy (all p>0.05).Conclusion: CHT/TRT could improve survival for ES-SCLC patients. TRT performed within 6 cycles CHT and receiving hyperfractionated 45Gy in 30 fractions may be a feasible treatment scheme for ES-SCLC patients.

scholarly journals Consolidative thoracic radiotherapy for extensive stage small cell lung cancer

Oncotarget ◽  
2017 ◽  
Vol 8 (13) ◽  
pp. 22251-22261 ◽  
Author(s):  
Xiaoli Zhang ◽  
Jinming Yu ◽  
Hui Zhu ◽  
Xue Meng ◽  
Minghuan Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung ◽  
Extensive Stage

scholarly journals Tumor response and progression-free survival as potential surrogate endpoints for overall survival in extensive stage small-cell lung cancer

Cancer ◽  
2010 ◽  
Vol 117 (6) ◽  
pp. 1262-1271 ◽  
Author(s):  
Nathan R. Foster ◽  
Yingwei Qi ◽  
Qian Shi ◽  
James E. Krook ◽  
John W. Kugler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Tumor Response ◽  
Progression Free Survival ◽  
Small Cell ◽  
Surrogate Endpoints ◽  
Small Cell Lung ◽  
Free Survival ◽  
Extensive Stage

scholarly journals Role of thoracic radiotherapy in extensive stage small cell lung cancer: a systemic review and meta-analysis

2021 ◽  
Vol 9 (4) ◽  
pp. 299-299
Author(s):  
Ao-Mei Li ◽  
Han Zhou ◽  
Yang-Yang Xu ◽  
Xiao-Qin Ji ◽  
Tian-Cong Wu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Meta Analysis ◽  
Small Cell ◽  
Systemic Review ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung ◽  
Extensive Stage

Immunotherapy versus standard chemotherapy for treatment of extensive-stage small-cell lung cancer: a systematic review

Immunotherapy ◽  
2021 ◽  
Author(s):  
Xingyu Liu ◽  
Huifang Xing ◽  
Hongbing Zhang ◽  
Hongyu Liu ◽  
Jun Chen
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Standard Chemotherapy ◽  
Free Survival ◽  
Extensive Stage

Aim: We conducted a systematic review and network meta-analysis to evaluate the efficacy of immunotherapy versus chemotherapy to treat extensive-stage small-cell lung cancer. Methods: We analyzed several eligible clinical trials using fixed or random-effects models to evaluate relative treatment effects depending on heterogeneity. Results: In the experimental group, immunotherapy showed significant improvement in overall survival (hazard ratio [HR]: 0.82; 95% CI: 0.74–0.89; I2 = 31.4%; p < 0.001) and progression-free survival (HR: 0.77; 95% CI: 0.80–0.83; I2 = 22.7%; p < 0.001). Conclusion: Immunotherapy is likely to significantly improve extensive-stage small-cell lung cancer patients' overall survival and progression-free survival compared with standard chemotherapy. Anti-PD L1 exhibited superior overall survival compared with anti-PD 1 and anti-CTLA4.

Carboplatin (CBDCA, JM-8) and VP-16-213 in previously untreated patients with small-cell lung cancer.

1987 ◽  
Vol 5 (10) ◽  
pp. 1574-1578 ◽  
Author(s):  
J F Bishop ◽  
D Raghavan ◽  
R Stuart-Harris ◽  
G Morstyn ◽  
R Aroney ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Relapse Free Survival ◽  
Who Grade ◽  
Free Survival ◽  
Limited Stage ◽  
Extensive Stage

The efficacy and toxicity of carboplatin 100 mg/m2, administered intravenously (IV) daily X 3, and VP-16-213 120 mg/m2, IV daily X 3, administered every 28 days for six courses, was assessed in 94 (36 limited stage, 58 extensive stage) previously untreated patients with small-cell lung cancer. Mediastinal irradiation using 50 Gy in 25 fractions was given to all limited-stage patients with a complete (CR) or partial response (PR) after three chemotherapy courses. Cranial irradiation was administered to all patients with CR. Objective responses were seen in 77% (CR 40%, PR 37%) of patients with limited-stage and 58% (CR, 9%; PR, 49%) with extensive-stage disease. Median relapse-free survival for objective responders with limited stage was 14.6 months and 7.9 months for extensive-stage patients. Median relapse-free survival following CR was 15.4 months and 8.5 months for PR. Median survival was 15.3 months for limited-stage and 8.1 months for extensive-stage patients. The combination was well tolerated with mild nausea or less (World Health Organization [WHO] grade 0 or 1) in 62% of patients and minimal mucositis, renal, neurotoxicity, or ototoxicity. Neutropenia less than 1.0 X 10(9)/L (WHO grade 3 or 4) was seen in 63% of patients, with two deaths from infection while neutropenic. The combination of carboplatin and VP-16-213 is a new, active program with low toxicity when applied intensively in previously untreated patients with small-cell lung cancer.

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