Chemotherapy combined with chest radiation therapy in the treatment of 95 patients with limited stage small cell lung cancer

Abstract

To analyse retrospectively the results and prognostic factors of 95 patients with limited stage small cell lung cancer treated with chemotherapy plus chest radiation therapy. Ninety-five patients with limited stage small cell lung cancer were treated with combination chemotherapy plus chest radiation therapy from December,1989 to June,1997.There were 84 males and 11 females with median age of 58 years (32-75 years).The P-TNM stages of the disease were as follows:stage I disease,3 patients; stage II disease,7 patients; stage IIIA disease,49 patients and stage IIIB disease,36 patients.Chemotherapy regimens were CAP (cyclophosphamide,doxorubicin,cisplatin),EP(etoposide,cisplatin),TP(Teniposide,cisplatin),or IEP (ifosphamide,etoposide,cisplatin).Median cycles were 6 (1-10).After one cycle of chemotherapy,patients received chest radiation therapy with median total tumor dose of 59.1Gy(43.8-76.9Gy)/31fx(22-64fx) for 48 days(30-73days).The radiation fields covered tumors with 1.5-2.0cm margins.Supraclavicular region and brain did not receive prophylactic irradiation. Of the ninety-five patients,55(58%) had a complete response,36(38%) had a partial response,three had a stable disease and one had a disease progression.The median survival time was 28 months.The 1-,2-,3- and 5-year survival rates were 85%,62%,31% and 13%,respectively.The 1-,2-,3-,and 5-year local control rates were 95%,86%,77% and 64%,respectively.The 1-,2-,3- and 5-year distant metastasis rates were 23%,52%,73%,and 83%,respectively.From multivariate regression analyses,KPS≥70 and complete response and partial response could be the favorable predictors. Chemotherapy combined with chest irradiation in limited stage small cell lung cancer can get better survival and local control and less distant metastases.KPS≥70 and complete response and partial response might be the favorable predictors.