Metastatic location of extensive stage small-cell lung cancer: implications for thoracic radiation
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This study was designed to evaluate the role of thoracic radiotherapy (TRT) in a selected patient population with oligometastatic extensive stage small-cell lung cancer (ES-SCLC) without brain or liver involved. The underlying hypothesis was that TRT will improve outcomes in this favorable patient population.
305 patients were included in an institutional review board (IRB)-approved study, of which 105 received TRT after chemotherapy (ChT) and 200 received ChT alone. The survival outcomes were compared between ChT+TRT group and ChT-alone group in patients with oligometastasis without brain or liver involved and patients with brain/liver/multimetastasis, respectively.
The 1-year, 2-year and 5-year overall survival (OS) for all patients were 60.3%, 23.9% and 1.6%, respectively. The addition of TRT significantly improved PFS in total patients than ChT alone (14.5 months vs. 10.1 months, p = 0.006), but the OS benefit was not significant (17.8 months vs. 16.5 months, p = 0.061). For patients with oligometastasis (n = 118), TRT offered significant progression free survival (PFS) (16.5 months vs. 9.1 months, p = 0.005) and OS (19.2 months vs. 15.6 months, p = 0.039) benefits. However, for patients with brain/liver/multimetastasis, the PFS and OS were not improved with TRT (p = 0.49, p = 0.811).
TRT provided significant PFS and OS benefits in patients with oligometastatic ES-SCLC without brain or liver involved. The consolidative TRT is a reasonable treatment option for this favorable patient population.
KeywordsExtensive stage small-cell lung cancer Thoracic radiation Metastatic location Oligometastasis Prognosis
FFT and JMY designed the study; HQZ, LD, XW, DYW collected and analyzed data; HQZ and FFT drafted the article.
This work was supported by Grants from the National Natural Science Foundation of China (NSFC 81803066).
Compliance with ethical standards
Conflict of interest
The authors have no disclosures.
The study has been reviewed and approved by the Ethics Committee of Shandong Cancer Hospital and Institute, China. Either a signed informed consent or authorisation from the National Supervisory for Welfare and Health was obtained for all patients. This study has been conducted according to the Declaration of Helsinki.
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