title: The role of second-line chemotherapy in small cell lung cancer: a retrospective analysis.
abstract: BACKGROUND
  To evaluate the benefit of second-line chemotherapy with platinum-based treatment in patients with recurrent small cell lung cancer (SCLC).
  
  
  METHODS
  A total of 535 patients continued with follow-up or best supportive care if needed, and 229 patients who progressed after the completion of first-line chemotherapy were treated with second-line chemotherapy at the time of progression. In total, 103/229 patients received paclitaxel 190 mg/m(2) and carboplatin 5.5 area under the curve while 126/229 patients received etoposide 200 mg/m(2) and carboplatin 5.5 area under the curve every 28 days.
  
  
  RESULTS
  Patients administered second-line chemotherapy lived significantly longer, with a median survival of 422 days compared to 228 days in patients with best supportive care alone (P<0.001). Patients who received paclitaxel as second-line chemotherapy lived for an average of 462 days (95% confidence interval: 409-514), versus 405 days in the etoposide group (95% confidence interval: 371-438), which was not statistically significant (P=0.086). The overall response rate was 8% for the paclitaxel group and 6% for the etoposide group. Patients with progression of the disease in more than 3 months had significantly better survival compared with those that progressed in less than 3 months (P<0.001).
  
  
  CONCLUSIONS
  Continuation with carboplatin/paclitaxel or carboplatin/etoposide as second-line chemotherapy has no significant survival impact, and it did not improve response rates.
authors.affiliation: Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.forename: Efimia
authors.initials: E
authors.lastname: Boutsikou
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.forename: Kaid
authors.initials: K
authors.lastname: Darwiche
authors.forename: Lutz
authors.initials: L
authors.lastname: Freitag
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Porpodis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Latsios
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kontakiotis
authors.forename: Haidong
authors.initials: H
authors.lastname: Huang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hohenforst-Schmidt
authors.forename: Maria
authors.initials: M
authors.lastname: Kipourou
authors.forename: J Francis
authors.initials: JF
authors.lastname: Turner
authors.forename: Dionysios
authors.initials: D
authors.lastname: Spyratos
keywords: SCLC; lung cancer; second-line