A comparative study of resection plus chemotherapy and chemoradiotherapy in limited-stage small cell lung cancer

Abstract

Objective The aim of this study was to evaluate the prognosis of resection followed by chemotherapy compared with chemoradiotherapy for limited-stage small cell lung cancer. Methods The clinical data of 230 limited-stage small cell lung cancer patients with curative treatment between January 2006 and December 2011 were retrospectively analyzed. All patients divided to two group: the resection plus chemotherapy (S+ C) and chemoradiotherapy (R+ C). And the prognostic factors were further analyzed with limited stage small cell lung cancer. The Kaplan-Meier method was used for the survival analysis. Results The overall survival rates of 1-year, 3-year and 5-year were 87.0%, 38.9%, 25.4%, respectively and the media survival time (MST) 26.0 months. When patients were stratified by clinical stageⅠ+ Ⅱ, the 1-year, 3-year and 5-year overall survival rates of S+ C group and R+ C group were 92.6%, 63.2%, 47.3% and 76.2%, 42.9%, 30.6%, respectively (χ2=7.851, P 0.05). In univariate analysis, tumor location, tumor stage, lymph node metastasis, TNM stage, the cycle of chemotherapy, treatment modalities were significantly associated with survival (RR=1.735, P<0.05). The multivariate analysis only showed TNM stage were independent factors of prognosis. Conclusions The results suggested that resection plus chemotherapy could improve the prognosis of early-stage(stageⅠ+ Ⅱ) small cell lung cancer, but patients in ⅢA stage should received the definitive chemoradiotherapy. The TNM stage was still the independent factor of prognosis. Key words: Limited-disease; Small cell lung cancer; Resection plus chemotherapy; Chemoradiotherapy; Prognostic