title: Outcome of patients with pulmonary carcinoid tumors receiving chemotherapy or chemoradiotherapy.
abstract: OBJECTIVE
  To determine the outcome of patients with pulmonary typical and atypical carcinoid tumors treated with chemotherapy with or without radiotherapy.
  
  
  METHODS
  Patients with pulmonary neuroendocrine tumors treated at our institution from 1990 to 2001 were identified. The medical records of patients with diagnoses of typical or atypical pulmonary carcinoids were reviewed for the presence of evaluable disease, treatment with chemotherapy with or without radiotherapy, response to these treatments, survival and cause of death.
  
  
  RESULTS
  Eighteen patients with typical (n = 8) or atypical (n = 10) pulmonary carcinoid tumors who were treated with chemotherapy with or without radiotherapy were identified. Of these, four received chemotherapy plus chest radiotherapy. Three of these had stable disease and one had a partial response. One of the patients with stable disease to chemoradiotherapy subsequently received chemotherapy alone, to which he had a complete response. Fourteen additional patients were treated with 18 chemotherapy regimens. There were two partial responses, eight stable disease, seven progressive disease and one allergic reaction precluding further treatment. The overall response rate to any chemotherapy was 3/15 (20%, 95% CI 0.07-0.45), and the best overall response rate to chemotherapy with or without chest radiotherapy was 4/18 (22%, 95% CI 0.09-0.45). Median overall survival was 20 months (95% CI 0-51 months).
  
  
  CONCLUSIONS
  Patients with typical and atypical pulmonary carcinoid tumors can respond to chemotherapy with or without chest radiotherapy, though with response rates that appear less than those of small cell lung cancers. Further characterization of pulmonary carcinoid tumors and study of treatment alternatives for unresectable disease is warranted.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA. lwirth@partners.org
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Wirth
authors.forename: Mark R
authors.initials: MR
authors.lastname: Carter
authors.forename: Pasi A
authors.initials: PA
authors.lastname: Jänne
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome