Clinical outcome of chemoradiotherapy in patients (pts) with limited-disease small-cell lung cancer (LD-SCLC) with ipsilateral pleural effusion

Abstract

7524 Background: The current standard care for LD-SCLC is a combination of chemotherapy and thoracic radiotherapy (TRT). However, the indications for definitive TRT in LD-SCLC and ipsilateral pleural effusion have not been thoroughly investigated. We retrospectively investigated the clinical course and outcome of LD-SCLC pts with ipsilateral pleural effusion. Methods: The medical records of SCLC pts who received treatment at the National Cancer Center Hospital East between July 1992 and December 2005 were reviewed. Fifty-six of the 338 LD-SCLC pts (17%, 95% CI: 13–21%) had ipsilateral pleural effusion 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 56 pts were divided into three subgroups: group A included pts who received chemotherapy and TRT (n=23), group B included pts who did not receive TRT in spite of the disappearance of pleural effusion after first-line chemotherapy (n=8), and group C included pts who did not receive TRT and whose pleural effusion persisted after first-line chemotherapy (n=25). Results: All the pts received platinum-based chemotherapy. The response rate was 71%. Ipsilateral pleural effusion disappeared after first-line chemotherapy in 31 pts (55%). The median overall survival time was 12.9 months (95% CI: 10.2–16.9), and the three and five-year survival rates were 14% and 10%, respectively. Four pts have survived for over five years. In groups A, B, and C, the median survival times were 19.2, 14.7, and 9.2 months, respectively, and the three-year survival rates were 22%, 13%, and 8%, respectively. Disease progression was confirmed in 18 of the 23 pts in group A. At the time of disease progression, ipsilateral pleural effusion recurred in 8 of the 18 pts. Conclusions: Long-term survival was achieved by LD-SCLC pts with ipsilateral pleural effusion who successfully underwent chemoradiotherapy. No significant financial relationships to disclose.