title: Chemoradiotherapy duration correlates with overall survival in limited disease SCLC patients with poor initial performance status who successfully completed multimodality treatment.
abstract: OBJECTIVE
  Limited data concerning treatment-related prognostic factors in limited disease (LD) small-cell lung cancer (SCLC) patients with poor initial performance status (PS) who successfully completed chemoradiotherapy (CRT) are available.
  
  
  METHODS
  A total of 125 patients with initial PS WHO 2-3 who successfully completed CRT were retrospectively reviewed. Thoracic radiation therapy (TRT) was applied in the concurrent (group 1) or sequential (group 2) mode. Influence of treatment type, time from diagnosis to start of TRT, number of chemotherapy cycles, prophylactic cranial irradiation (PCI), occurrence of brain metastases (BMs), and duration of CRT on overall survival (OS) were analyzed.
  
  
  RESULTS
  Median duration of CRT was 156 days in group 1 and 195 days in group 2 (p < 0.001). Median progression-free survival and OS were 11.6 (95% confidence interval (CI) 10-13.2) and 14.9 (95% CI 11.7-17.6) months with no difference between the groups. The 2- and 3-year survival rates were 37.9 ± 6.9% and 22.7 ± 6.3% in group 1 and 22.4 ± 4.9% and 15.2 ± 4.3% in group 2, respectively. Duration of CRT was only treatment-related factor predicting OS in the uni- (p < 0.014) and multivariate (p < 0.025) analyses. Short dose-dense CRT was associated with improved OS.
  
  
  CONCLUSIONS
  Duration of CRT affects OS in LD SCLC patients with poor initial performance status who successfully completed multimodality treatment.
authors.affiliation: Department of Radiation Oncology, Ludwig-Maximilians-University Munich, Marchioninistra.15, 81377, Munich, Germany. Farkhad.Manapov@med.uni-muenchen.de
authors.forename: F
authors.initials: F
authors.lastname: Manapov
authors.forename: S
authors.initials: S
authors.lastname: Klöcking
authors.forename: M
authors.initials: M
authors.lastname: Niyazi
authors.forename: C
authors.initials: C
authors.lastname: Belka
authors.forename: G
authors.initials: G
authors.lastname: Hildebrandt
authors.forename: R
authors.initials: R
authors.lastname: Fietkau
authors.forename: G
authors.initials: G
authors.lastname: Klautke
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008207:Lymphatic Metastasis / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011880:Radiotherapy Planning, Computer-Assisted; D011882:Radiotherapy, High-Energy / Q000379:methods; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D015996:Survival Rate