Abstract
Objective
Stage I small cell lung cancer (SCLC) is rare, and current treatment approach supports surgical resection with adjuvant platinum chemotherapy. Stereotactic body radiation therapy (SBRT) is an excellent alternative to surgery in inoperable non-small cell lung cancer, but its role in the management of stage I SCLC is not well-defined.
Methods
Eight patients with stage I SCLC who received SBRT due to surgical contraindications and three patients who received SBRT as salvage for recurrent stage I SCLC originally treated with fractionated radiation and chemotherapy were identified. Patients were treated with 50 Gy in four fractions. Adjuvant chemotherapy was given as the discretion of the treating oncologists. Data was analyzed using Kaplan-Meier survival estimates.
Results
Five of the eight primary patients were treated with SBRT and adjuvant chemotherapy. The local recurrence-free survival, recurrence-free survival, and overall survival were 100, 50, and 88 % for all eight patients at 1 year. Overall survival and recurrence-free survival of all primary treated patients at 3 years was 37 and 38 %. However, patients who received chemotherapy after SBRT gave a 3-year overall and recurrence-free survival of 60 and 60 %. The three patients who received SBRT salvage therapy for recurrent stage I SCLC had mixed results. Results from two similar studies that evaluated the use of SBRT for stage I SCLC were reviewed.
Conclusion
SBRT is a reasonable approach for stage I SCLC patients who are unfit for surgery followed by adjuvant platinum-based chemotherapy +/− prophylactic cranial irradiation.
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Acknowledgments
This study was supported in part by the Cancer Center Support (Core) Grant CA016672 to The University of Texas MD Anderson Cancer Center. All patients included in this study consented to have their treatment information included in clinical databases for research purposes.
Ethical standard
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Conflict of interest
Ngoc B. Ly, Pamela K. Allen, and Steven H. Lin declare that they have no conflict of interest.
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Ly, N.B., Allen, P.K. & Lin, S.H. Stereotactic body radiation therapy for stage I small cell lung cancer: a single institutional case series and review of the literature. J Radiat Oncol 3, 285–291 (2014). https://doi.org/10.1007/s13566-014-0146-7
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DOI: https://doi.org/10.1007/s13566-014-0146-7