Treatment time to the end of thoracic radiotherapy has more predictive power for survival than radiation dose intensity in patients with limited‑stage small‑cell lung cancer receiving concurrent chemoradiation of more than 45 Gy

Jeong,Jae‑Uk; Jeon,Wan; Ahn,Sung‑Ja; Kim,Young‑Chul; Oh,In‑Jae; Park,Chul‑Kyu; Yoon,Mee  Sun; Song,Ju‑Young; Nam,Taek‑Keun; Chung,Woong‑Ki

doi:10.3892/ol.2019.11107

Treatment time to the end of thoracic radiotherapy has more predictive power for survival than radiation dose intensity in patients with limited‑stage small‑cell lung cancer receiving concurrent chemoradiation of more than 45 Gy

Authors:
- Jae‑Uk Jeong
- Wan Jeon
- Sung‑Ja Ahn
- Young‑Chul Kim
- In‑Jae Oh
- Chul‑Kyu Park
- Mee Sun Yoon
- Ju‑Young Song
- Taek‑Keun Nam
- Woong‑Ki Chung
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Affiliations: Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Hwasun‑gun, Jeollanam‑do 58128, Republic of Korea, Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Gijang‑gun, Busan 46033, Republic of Korea, Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun‑gun, Jeollanam‑do 58128, Republic of Korea
Published online on: November 18, 2019 https://doi.org/10.3892/ol.2019.11107
Pages: 239-246
Copyright: © Jeong et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The optimal protocol for thoracic radiotherapy (TRT) in combination with chemotherapy in patients with limited‑stage small‑cell lung cancer (LS‑SCLC) remains elusive. The present study aimed to evaluate radiation parameters in association with survival outcomes. A total of 101 patients with LS‑SCLC who completed TRT at ≥45 Gy and concurrent chemotherapy were retrospectively reviewed. The median dose and duration of TRT were 50 Gy and 38 days, respectively. The median duration from the start of either therapy to the end of TRT (SER) was 60 days. The median survival for all patients was 26.9 months. The 3‑year local control (LC), progression‑free survival (PFS) and overall survival (OS) rates were 52.0, 29.5 and 37.6%, respectively, and the 5‑year LC, PFS and OS rates were 50.1, 28.3 and 26.7%, respectively. Univariate analysis revealed that patient age, tumor stage, timing and dose of TRT, SER, prophylactic cranial irradiation (PCI), and tumor response were significantly associated with treatment outcomes. Multivariate analysis revealed that stage was the only significant prognostic factor for LC (P=0.011), PFS (P<0.001) and OS (P<0.001). Tumor response (P=0.014), PCI (P=0.007) and SER (P=0.005) were significant predictors of OS. OS was improved in patients who achieved complete response, and their SER was ≤70 days (P<0.001). Short treatment duration (SER ≤70 days) was a significant predictor of OS in patients with LS‑SCLC who completed planned TRT at ≥45 Gy with concurrent chemoradiotherapy.

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