Clinical Outcome of Chemoradiation Therapy in Patients with Limited-Disease Small Cell Lung Cancer with Ipsilateral Pleural Effusion

Abstract

The indications for definitive thoracic radiotherapy (TRT) in limited-disease small cell lung cancer (LD-SCLC) and ipsilateral pleural effusion have not been thoroughly investigated. We retrospectively investigated the clinical outcome of LD-SCLC patients with ipsilateral pleural effusion. The medical records of SCLC patients who received treatment at the National Cancer Center Hospital East between July 1992 and December 2006 were reviewed. Sixty-three of the 373 LD-SCLC patients (17%) had ipsilateral pleural effusion. Of these, 62 patients received chemotherapy as an initial treatment, and were included in this study. Since about 1998, definitive TRT was routinely performed if the patient's pleural effusion disappeared after induction chemotherapy. The 62 patients were divided into three subgroups: group A included patients who received chemotherapy and TRT (n = 26), group B included patients who did not receive TRT in spite of the disappearance of pleural effusion after first-line chemotherapy (n = 8), and group C included patients who did not receive TRT and whose pleural effusion persisted after first-line chemotherapy (n = 28). The response rate for first-line chemotherapy was 74%. Ipsilateral pleural effusion disappeared after first-line chemotherapy in 34 patients (55%). The median overall survival time was 11.8 months, and the 2 and 3-year survival rates were 21 and 10%, respectively. In groups A, B, and C, the median survival times were 19.2, 10.5, and 9.2 months, respectively, and the 2-year survival rates were 38, 25, and 7%, respectively. Long-term survival was achieved by LD-SCLC patients with ipsilateral pleural effusion who successfully underwent chemoradiotherapy.