Limited-stage small-cell lung cancer treated with early chemo-radiotherapy: The impact of effective chemotherapy

Vieri Scotti, Icro Meattini, Calogero Saieva, Andrea Rampini, Carla De Luca Cardillo, Paolo Bastiani, Monica Mangoni, Benedetta Agresti, Carmine Santomaggio, Vanessa Di Cataldo, Ciro Franzese, Lorenzo Livi, Stefano Maria Magrini, Giampaolo Biti

Research output: Contribution to journalArticlepeer-review

Abstract

Aims and background. Small cell lung cancer is characterized by an aggressive clinical course and a high sensitivity to both chemotherapy and radiotherapy. We present the Florence University experience in concurrent early radio-chemotherapy in patients affected by limited-stage small cell lung cancer, with particular emphasis on treatment safety, disease outcome and prognostic factors. Methods and study design. Fifty-seven patients were treated between June 2000 and February 2005. All patients underwent platinum-based chemotherapy, administered intravenously following two different regimens, for at least three cycles. Eighteen patients (31.6%) received epirubicin and ifosfamide in 3-week cycles alternating with etoposide and cisplatin, administered on day 1 to 3; 39 patients (68.4%) received etoposide and cisplatin. A total of 6 cycles were planned. Radiotherapy was administered concurrently to the first cycle of etoposide and cisplatin. Results. Clinical stage (P = 0.036) and number of chemotherapy courses (P = 0.009) emerged as the only significant death predictors at univariate analysis. Number of chemotherapy courses persisted as a significant death predictor also at multivariate regression analysis, with a reduced death risk for 5-6 chemotherapy cycles in comparison to 3-4 cycles (hazard ratio, 0.44). At a mean follow up of 38.5 months (standard deviation, 3.24 years; range, 6-164 months), considering the best overall tumor response achieved at any time during the whole treatment period, we obtained 32 complete responses (56.1%), 23 partial responses (40.3%) and 2 stable diseases. Conclusions. Our analysis showed that concurrent early radio-chemotherapy in limited-stage small cell lung cancer treatment represents a safe and effective approach in patients. We confirmed the relevant impact on overall survival of effective chemotherapy delivery.

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalTumori
Volume98
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • Concurrent treatment
  • Early chemotherapy radiotherapy
  • Limited stage
  • Small cell lung cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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