title: Karnosky Performance Score and Radiation Dose Predict Survival of Patients Re-irradiated for a Locoregional Recurrence of Small Cell Lung Cancer.
abstract: OBJECTIVE
  When patients with small cell lung cancer (SCLC) experience locoregional recurrence, surgery is often not employed as salvage therapy. Systemic chemotherapy and radiotherapy are often used. Many radiation oncologists are reluctant to deliver a second course of radiotherapy. However, select patients may benefit from re-irradiation. This study aimed to identify these patients.
  
  
  METHODS
  In patients receiving re-irradiation for a locoregional recurrence of SCLC, 11 potential prognostic factors were analyzed for survival.
  
  
  RESULTS
  Survival was positively associated with a Karnofsky performance score ≥80 (p=0.003) and a cumulative dose >90 Gy (p=0.026). A trend was observed for younger age, longer interval between first course of radiotherapy and re-irradiation, a greater dose of re-irradiation and for concurrent chemotherapy.
  
  
  CONCLUSIONS
  Significant predictors of survival in patients re-irradiated for a locoregional recurrence of SCLC were identified. Patients with a good performance status can benefit from re-irradiation if administered in sufficient doses.
authors: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors: Lukas
authors: L
authors: Käsmann
authors: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
authors: Stefan
authors: S
authors: Janssen
authors: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors: Steven E
authors: SE
authors: Schild
authors: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
authors: Dirk
authors: D
authors: Rades
mesh_terms: D000367:Age Factors; D000368:Aged; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D018579:Patient Selection; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D019233:Retreatment; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Karnofsky performance score; Small cell lung cancer; re-irradiation; recurrence; survival