[Retrospective analysis of patients with small cell lung cancer treated at Gazi University Department of Radiation Oncology].
The combination of radiotherapy (RT) and chemotherapy (CT) is the main treatment modality of limited-stage small cell lung cancer (SCLC). The application of radiation timing, doses, fraction schedules in this modality and the indication of prophylactic cranial irradiation is recently controversial. In this retrospective study, these subjects were evaluated by considering our patients results. Seventy patients having adequate data for examination with limited-stage SCLC were referred to our clinic in the period between December 1995 and December 2002. The patients were classified according to their response to CT, the dose and timing of RT applications. The effects of obtained variables on overall survival were analyzed. Male/ female ratio was 5/1; and the mean age was 55 years (range 31-80 years). The mean follow-up of all patients was 10 months and the mean survival time was 16 months. An objective (complete and partial) response to CT administered before RT was seen in 47 (67%) patients. The survival time was better in the CT responding patients (median 11 months versus 6 months, p= 0.002). The application of more than 50 Gy radiation dose was found to be ineffective on survival. An improvement in survival was observed in RT application beginning before fourth cycle CT (median 14 months versus 8 months p= 0.01). In despite of the ineffectiveness of prophylactic cranial irradiation on survival is observed in survival analysis, it was found to be a parameter affecting survival in Cox-regression analysis. However the most frequently complication during RT was oesophagitis. Grade III was seen in 1 (3%) patient. The response to CT can be accepted as an indicator for survival. We concluded that the administering of RT in the beginning of CT, not administering radiation doses of more than 50 Gy and the necessity of applying prophylactic cranial irradiation to all patients showing complete response are points to be considered according to our retrospective analysis.
Erpolat
O Petek
OP
Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey. petektater@yahoo.com
Göksel
Fatih
F
Bora
Hüseyin
H
Akmansu
Müge
M
Unsal
Diclehan
D
Oztürk
Can
C
Egehan
Ibrahim
I
Aşikoğlu
Haluk
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011829:Radiation Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology