title: Impact of the Radiation Dose on Survival after Radiochemotherapy for Small-cell Lung Cancer.
abstract: OBJECTIVE
  Radiochemotherapy for small-cell lung cancer may not be sufficiently tolerated by all patients. To contribute to better personalization of the radiochemotherapy programs, this study compared two radiotherapy doses and 10 characteristics for survival.
  
  
  METHODS
  In 71 patients receiving radiochemotherapy for small-cell lung cancer, the radiation dose given as equivalent dose in 2 Gy fractions (EQD2: <56 vs. ≥56 Gy) plus 10 characteristics, namely gender, age, Karnofsky performance score, T-category, N-category, tumor stage, pack years, smoking during radiotherapy, respiratory insufficiency and hemoglobin prior to radiotherapy, were evaluated for survival.
  
  
  RESULTS
  On multivariate analysis, EQD2 ≥56 Gy (p=0.003), female gender (p=0.029), Karnofsky performance score >70 (p<0.001), very limited disease (p=0.043) and pre-radiotherapy hemoglobin ≥12 g/dl (p=0.044) were significantly associated with better survival.
  
  
  CONCLUSIONS
  This study identified several independent predictors of survival after radiochemotherapy of small-cell lung cancer. A radiation dose of ≥56 Gy resulted in better survival than lower doses.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Käsmann
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Small-cell lung cancer; potential prognostic factors; radiation dose; radiochemotherapy; survival