title: Treatment modality selection and prognosis of early stage small cell lung cancer: retrospective analysis from a single cancer institute.
abstract: We evaluated the role of surgery followed by either chemotherapy (ChT) alone or chemotherapy and thoracic radiotherapy (ChT/TRT) versus sequential ChT/TRT in patients with clinical stage I or stage II small cell lung cancer (SCLC). Ninety-six patients received surgery (complete resection) followed by either ChT alone or ChT/TRT (Group I), while 49 patients were treated exclusively with sequential ChT/TRT (Group II). The ChT regimens consisted of either carboplatin/etoposide or cisplatin/etoposide. The total TRT dose was 50-60 Gy. For the whole group (n = 145), the median survival time was 54 months, and the 5-year overall survival (OS) rate was 48%. The corresponding figures for Group I were 91 months and 57%, respectively, and for Group II, they were 34.6 months and 31.4% respectively (P = 0.004). Multivariate analysis revealed that a Karnofsky Performance Status score ≥ 80 [hazard ratio (HR), 0.281; P = 0.015] and the treatment modality including surgery (HR, 0.503; P = 0.004) were independent favourable prognostic factors for OS.
authors.affiliation: Department of Radiation Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Science (CAMS) & Peking Union Medical College, Beijing, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhu
authors.forename: Z
authors.initials: Z
authors.lastname: Zhou
authors.forename: Q
authors.initials: Q
authors.lastname: Xue
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: He
authors.forename: L
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis
keywords: chemoradiotherapy; overall survival; small cell lung cancer; surgery