title: Outcomes of second-line chemotherapy in patients with relapsed extensive small cell lung cancer.
abstract: BACKGROUND
  Extensive-disease small cell lung cancer (ED SCLC) is characterized by initial chemosensitivity, followed inevitably by relapse. The optimal role of additional chemotherapy at the time of progression is controversial. We reviewed the experience of all patients over a 5-year period with ED SCLC to describe outcomes of second-line chemotherapy.
  
  
  METHODS
  Records of all patients registered at The Ottawa Hospital Regional Cancer Centre with ED SCLC were reviewed, and baseline prognostic factors, chemotherapy delivered, and treatment outcomes were extracted. Multivariate analyses were performed to determine the effect of second-line chemotherapy on survival.
  
  
  RESULTS
  Of 192 patients who completed first-line chemotherapy, only 62 (32%) received second-line therapy; these patients were younger and fitter, and lived longer from the time of relapse (5.2 vs. 1.5 months). Second-line therapy was an independent predictor of survival. Benefit was observed in patients with relapse either before or after 60 days from the completion of first-line therapy.
  
  
  CONCLUSIONS
  Second-line chemotherapy given at the time of relapse of ED SCLC seems to be associated with prolongation of survival, even in patients traditionally felt to have chemoresistant disease. The majority of patients, however, do not receive second-line therapy because of poor clinical status at relapse.
authors.affiliation: Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Froeschl
authors.forename: Garth
authors.initials: G
authors.lastname: Nicholas
authors.forename: Victor
authors.initials: V
authors.lastname: Gallant
authors.forename: Scott A
authors.initials: SA
authors.lastname: Laurie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents