PMID- 33663551
OWN - NLM
STAT- MEDLINE
DCOM- 20211108
LR  - 20211108
IS  - 1748-717X (Electronic)
IS  - 1748-717X (Linking)
VI  - 16
IP  - 1
DP  - 2021 Mar 4
TI  - Clinical outcomes of extensive-stage small cell lung cancer patients treated with 
      thoracic radiotherapy at different times and fractionations.
PG  - 47
LID - 10.1186/s13014-021-01773-x [doi]
LID - 47
AB  - 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.
FAU - Han, Jinmin
AU  - Han J
AD  - Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, 250117, Shandong, China.
AD  - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, 250117, Shandong, China.
FAU - Fu, Chengrui
AU  - Fu C
AD  - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, 250117, Shandong, China.
AD  - Department of Radiation Oncology, Tianjin Medical University Cancer Institute and 
      Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer 
      Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 
      300060, China.
FAU - Li, Baosheng
AU  - Li B
AUID- ORCID: 0000-0002-5390-7269
AD  - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, 
      Shandong First Medical University and Shandong Academy of Medical Sciences, 
      Jinan, 250117, Shandong, China. bsli@sdfmu.edu.cn.
LA  - eng
GR  - ZR2016HP32/Natural Science Foundation of Shandong Province/
PT  - Journal Article
DEP - 20210304
PL  - England
TA  - Radiat Oncol
JT  - Radiation oncology (London, England)
JID - 101265111
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/drug therapy/mortality/pathology/*radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Radiotherapy, Adjuvant
MH  - Retrospective Studies
MH  - Small Cell Lung Carcinoma/drug therapy/mortality/pathology/*radiotherapy
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
PMC - PMC7934361
OTO - NOTNLM
OT  - Extensive small cell lung cancer
OT  - Prognosis
OT  - Radiation dose/fractionation
OT  - Radiation time
OT  - Thoracic radiation therapy
COIS- The authors declare no competing interests.
EDAT- 2021/03/06 06:00
MHDA- 2021/11/09 06:00
PMCR- 2021/03/04
CRDT- 2021/03/05 05:40
PHST- 2020/08/31 00:00 [received]
PHST- 2021/02/18 00:00 [accepted]
PHST- 2021/03/05 05:40 [entrez]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2021/11/09 06:00 [medline]
PHST- 2021/03/04 00:00 [pmc-release]
AID - 10.1186/s13014-021-01773-x [pii]
AID - 1773 [pii]
AID - 10.1186/s13014-021-01773-x [doi]
PST - epublish
SO  - Radiat Oncol. 2021 Mar 4;16(1):47. doi: 10.1186/s13014-021-01773-x.