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Medical Oncology

, 35:45 | Cite as

The effect of post-progression survival on overall survival among patients with sensitive relapse of small cell lung cancer

  • Yosuke Miura
  • Hisao Imai
  • Reiko Sakurai
  • Kyoichi Kaira
  • Noriaki Sunaga
  • Koichi Minato
  • Ryusei Saito
  • Takeshi Hisada
Original Paper

Abstract

Recent studies have suggested that, among patients with advanced lung cancer, subsequent treatment after failure of first-line or second-line chemotherapy has a greater effect on overall survival (OS) than tumor shrinkage or progression-free survival (PFS). However, no studies have examined this issue among patients with sensitive relapse of small cell lung cancer (SCLC). We retrospectively evaluate 77 patients with sensitive relapse of SCLC who received second-line chemotherapy after first-line platinum doublet chemotherapy between January 1999 and November 2013. The analyses included patient characteristics, treatment parameters, tumor shrinkage, PFS, post-progression survival (PPS), and OS. Spearman rank correlation analysis and linear regression analysis revealed that PPS was strongly correlated with OS (r = 0.91, p < 0.01, R2 = 0.96), PFS was moderately correlated with OS (r = 0.58, p < 0.01, R2 = 0.28), and tumor shrinkage was weakly correlated with OS (r = 0.34, p < 0.01, R2 = 0.12). A multivariate Cox proportional hazards model with a stepwise regression procedure revealed that PPS was significantly associated with age at the start of second-line chemotherapy, best response to second-line and third-line chemotherapy, and the number of regimens after progression beyond second-line chemotherapy (p < 0.05). These findings suggest that PPS has a stronger effect than PFS on OS among patients with sensitive relapse of SCLC. Thus, response to second-line chemotherapy and subsequent treatment for disease progression after second-line chemotherapy may be important factors that influence OS.

Keywords

Small cell lung cancer Sensitive relapse Post-progression survival Overall survival 

Notes

Acknowledgements

The authors thank Dr. Sakae Fujimoto (Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Japan) and Dr. Masanobu Yamada (Department of Endocrinology and Diabetes, Gunma University Graduate School of Medicine, Japan) for assisting with the preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

The study’s protocol complied with the Declaration of Helsinki and was approved by the institutional review boards of Gunma Prefectural Cancer Center and Shibukawa Medical Center. Formal consent of patients was not required for this type of retrospective study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Respiratory MedicineGunma Prefectural Cancer CenterOtaJapan
  2. 2.Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiJapan
  3. 3.Division of Respiratory MedicineNational Hospital Organization Shibukawa Medical CenterShibukawaJapan
  4. 4.Department of Oncology Clinical DevelopmentGunma University Graduate School of MedicineMaebashiJapan

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