Clinical Study

Sequential chemotherapy followed by radical thoracic radiotherapy (50 Gy in 25 fractions) in limited stage small cell lung cancer

9 Mar 2020
Muhammad Shahid Iqbal, Joseph Carlow, Fiona McDonald, Philip Atherton, Helen Turnbull, Sandeep Singhal, Timothy Simmons, Paula Mulvenna, Josef Kovarik, Rhona McMenemin, Jill Gardiner, Alastair Greystoke

Introduction: For limited stage small cell lung cancer (LS-SCLC) where concurrent chemoradiotherapy is inappropriate due to tumour bulk, co-morbidities or performance status, sequential treatment using chemotherapy followed by radiotherapy is the standard of care. The outcomes are not well established; we assessed in a single institution, the survival of these patients, prognostic factors and compared to the limited existing literature.

Materials and Method: Retrospective data was collected on all 59 patients diagnosed with LS-SCLC from 2011 to 2016 who received chemotherapy consisting of Carboplatin or Cisplatin Etoposide followed by thoracic radiotherapy (50 Gy in 25 fractions) /- prophylactic cranial irradiation (PCI).

Results: Median age at diagnosis was 66 years (range 46–90). Patients received a median of four cycles of chemotherapy (range: 1–6) and all the patients completed a full course of radiotherapy with only one patient experiencing grade >2 radiation induced toxicity. With a median follow up of 20.6 months, 45 patients had died with a median survival of 20.6 months. 2-year overall survival (OS) rates were 42%. Age using a cut-off of 65 was prognostic (median OS 25.6 months ≤65 years versus 14.1 months >65 years, p = 0.013) but gender, stage and receipt of PCI were not.

Conclusions: Most of the literature reporting outcome from sequential treatment in LS-SCLC is old and used a variety of radiotherapy regimens. Our data shows inferior outcomes to the gold standard concurrent chemoradiotherapy but support its usage in less fit patients with reasonable outcome observed.

Related Articles

Agustin Buero, Domingo J Chimondeguy, Rodolfo Auvieux, Gustavo A Lyons, Leonardo G Pankl, Guillermo Puchulo, Silvia Quadrelli
Severyn Ferneza, Markiyan Fetsych, Roman Shuliak, Halyna Makukh, Natalia Volodko, Roman Yarema, Tara Fetsych
Eduardo Payet, Joan Perez, Gustavo Sarria, Silvia Neciosup, Francisco Berrospi, Sheila Vilchez, Jorge Dunstan, Ronald Perez, Mauricio Vassallo, Santiago Salgado, Nanto Caparachín, Joseph A Pinto, Alexis Holguin
Bettina Müller, Carlos García, José A Sola, Wanda Fernandez, Patrick Werner, Mauricio Cerda, Jeannie Slater, Carlos Benavides, Jorge Arancibia, Rodrigo Ascui, Felipe Reyes, Mary Anne Stevens, Juan Pablo Miranda, Martin Buchholtz, Alejandro Corvalan