Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis
Background The role of thoracic radiation therapy (TRT) after chemotherapy (CHT) in extensive‐stage small cell lung cancer (ES‐SCLC) has not been well defined. We investigated whether intensity‐modulated radiotherapy (IMRT) improves outcomes in ES‐SCLC after CHT compared to CHT alone. Methods A tota...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-04-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13001 |
| _version_ | 1797845450964860928 |
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| author | Lei Deng ZongMei Zhou ZeFen Xiao DongFu Chen QinFu Feng Jun Liang JiMa Lv XiaoZhen Wang Nan Bi Xin Wang Tao Zhang WenQing Wang LvHua Wang |
| author_facet | Lei Deng ZongMei Zhou ZeFen Xiao DongFu Chen QinFu Feng Jun Liang JiMa Lv XiaoZhen Wang Nan Bi Xin Wang Tao Zhang WenQing Wang LvHua Wang |
| author_sort | Lei Deng |
| collection | DOAJ |
| description | Background The role of thoracic radiation therapy (TRT) after chemotherapy (CHT) in extensive‐stage small cell lung cancer (ES‐SCLC) has not been well defined. We investigated whether intensity‐modulated radiotherapy (IMRT) improves outcomes in ES‐SCLC after CHT compared to CHT alone. Methods A total of 292 patients who reached a complete response (CR), partial response (PR), or stable disease (SD) after CHT were assigned into groups: CHT + TRT and CHT alone. Propensity score matching was used to balance patient groups (n = 72 each). Results The five‐year overall survival (OS: 12.3% vs. 3.6%; P < 0.001) and progression‐free survival (PFS: 3.2% vs. 1.7%; P = 0.006) rates were significantly higher in the CHT + TRT group. This data was confirmed in the matched samples (5‐year OS: 10.5% vs. 1.6%, P < 0.001; PFS: 4.3% vs. 0.0%, P = 0.023). The overall (P = 0.002) and locoregional (P < 0.001) recurrence rates in the CHT + TRT group were significantly lower than in the CHT group. Univariate analysis showed that response evaluation after CHT and TRT were significant prognostic factors of OS. Multivariate analyses revealed that N Stage 0–1 (P = 0.02), > 6 cycles of CHT (P = 0.042), CR + PR after CHT (P < 0.001), and TRT (P < 0.001) were independently associated with longer OS compared to CHT alone. Conclusion TRT using IMRT is strongly correlated with improved OS and PFS in ES‐SCLC patients reaching CR, PR or SD after CHT. A multicenter, randomized phase III clinical trial is needed to confirm these findings. |
| first_indexed | 2024-04-09T17:39:15Z |
| format | Article |
| id | doaj.art-19c1b67bd3c8452ca46430108bd9ec07 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-09T17:39:15Z |
| publishDate | 2019-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-19c1b67bd3c8452ca46430108bd9ec072023-04-17T06:34:28ZengWileyThoracic Cancer1759-77061759-77142019-04-0110479980610.1111/1759-7714.13001Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysisLei Deng0ZongMei Zhou1ZeFen Xiao2DongFu Chen3QinFu Feng4Jun Liang5JiMa Lv6XiaoZhen Wang7Nan Bi8Xin Wang9Tao Zhang10WenQing Wang11LvHua Wang12National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaBackground The role of thoracic radiation therapy (TRT) after chemotherapy (CHT) in extensive‐stage small cell lung cancer (ES‐SCLC) has not been well defined. We investigated whether intensity‐modulated radiotherapy (IMRT) improves outcomes in ES‐SCLC after CHT compared to CHT alone. Methods A total of 292 patients who reached a complete response (CR), partial response (PR), or stable disease (SD) after CHT were assigned into groups: CHT + TRT and CHT alone. Propensity score matching was used to balance patient groups (n = 72 each). Results The five‐year overall survival (OS: 12.3% vs. 3.6%; P < 0.001) and progression‐free survival (PFS: 3.2% vs. 1.7%; P = 0.006) rates were significantly higher in the CHT + TRT group. This data was confirmed in the matched samples (5‐year OS: 10.5% vs. 1.6%, P < 0.001; PFS: 4.3% vs. 0.0%, P = 0.023). The overall (P = 0.002) and locoregional (P < 0.001) recurrence rates in the CHT + TRT group were significantly lower than in the CHT group. Univariate analysis showed that response evaluation after CHT and TRT were significant prognostic factors of OS. Multivariate analyses revealed that N Stage 0–1 (P = 0.02), > 6 cycles of CHT (P = 0.042), CR + PR after CHT (P < 0.001), and TRT (P < 0.001) were independently associated with longer OS compared to CHT alone. Conclusion TRT using IMRT is strongly correlated with improved OS and PFS in ES‐SCLC patients reaching CR, PR or SD after CHT. A multicenter, randomized phase III clinical trial is needed to confirm these findings.https://doi.org/10.1111/1759-7714.13001Carcinoma, small cellchemotherapyintensity‐modulatedlung neoplasmradiotherapy |
| spellingShingle | Lei Deng ZongMei Zhou ZeFen Xiao DongFu Chen QinFu Feng Jun Liang JiMa Lv XiaoZhen Wang Nan Bi Xin Wang Tao Zhang WenQing Wang LvHua Wang Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis Thoracic Cancer Carcinoma, small cell chemotherapy intensity‐modulated lung neoplasm radiotherapy |
| title | Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis |
| title_full | Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis |
| title_fullStr | Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis |
| title_full_unstemmed | Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis |
| title_short | Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis |
| title_sort | impact of thoracic radiation therapy after chemotherapy on survival in extensive stage small cell lung cancer a propensity score matched analysis |
| topic | Carcinoma, small cell chemotherapy intensity‐modulated lung neoplasm radiotherapy |
| url | https://doi.org/10.1111/1759-7714.13001 |
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