title: Radiotherapy timing in the treatment of limited-stage small cell lung cancer: the impact of thoracic and brain irradiation on survival.
abstract: OBJECTIVE
  Small cell lung cancer is an aggressive histologic subtype of lung cancer in which the role of chemotherapy and radiotherapy has been well established in limited-stage disease. We retrospectively reviewed a series of limited-stage small cell lung cancers treated with chemotherapy and thoracic and brain radiotherapy.
  
  
  METHODS
  A total of 124 patients affected by limited-stage small cell lung cancer has been treated over 10 years in our Institute. Fifty-three patients (42.8%) had concomitant radio-chemotherapy treatment and 71 patients (57.2%) a sequential treatment. Eighty-eight patients (70.9%) underwent an association of a platinum-derived drug (cisplatinum or carboplatinum) and etoposide. Prophylactic cranial irradiation was planned in all patients with histologically proven complete response to primary radio-chemotherapy.
  
  
  RESULTS
  With a mean follow-up of 2.2 years, complete response was obtained in 50.8% of cases. We found a significant difference between different radio-chemotherapy association approaches (P = 0.007): percentages of overall survival were respectively 10.0%, 12.9% and 5.6% in early, late concomitant and sequential radio-chemotherapy timing. Cranial prophylaxis did not seem to influence overall survival (P = 0.21) or disease-free survival for local relapse (P = 0.34).
  
  
  CONCLUSIONS
  Concomitant radio-chemotherapy is the best approach according to our experience. Our results show a benefit of prophylactic cranial irradiation in distant metastasis-free survival.
authors: Vieri
authors: V
authors: Scotti
authors: Icro
authors: I
authors: Meattini
authors: Ciro
authors: C
authors: Franzese
authors: Calogero
authors: C
authors: Saieva
authors: Silvia
authors: S
authors: Bertocci
authors: Fiammetta
authors: F
authors: Meacci
authors: Ilaria
authors: I
authors: Furfaro
authors: Daniele
authors: D
authors: Scartoni
authors: Sara
authors: S
authors: Cecchini
authors: Isacco
authors: I
authors: Desideri
authors: Katia
authors: K
authors: Ferrari
authors: Alessio
authors: A
authors: Bruni
authors: Carla
authors: C
authors: De Luca Cardillo
authors: Paolo
authors: P
authors: Bastiani
authors: Benedetta
authors: B
authors: Agresti
authors: Monica
authors: M
authors: Mangoni
authors: Lorenzo
authors: L
authors: Livi
authors: Giampaolo
authors: G
authors: Biti
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000532:radiotherapy* / Q000556:secondary; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome