Timing of radiotherapy for limited-stage small cell lung cancer in the elderly

Abstract

Objective To investigate the effect of the timing of radiotherapy on the prognosis of limited-stage small cell lung cancer (LS-SCLC) in the elderly. Methods A retrospective analysis was performed on the clinical data of 80 elderly patients with LS-SCLC who were treated with radical sequential thoracic chemoradiotherapy from 2008 to 2014.The correlations of SER (time from the start of any treatment to the end of radiotherapy) and the number of induction chemotherapy cycles with overall survival (OS) and progression-free survival (PFS) rates was analyzed. The treatment outcomes were compared between early radiotherapy group (no later than 3 cycles of induction chemotherapy, n=37) and late radiotherapy group (after 3 cycles of induction chemotherapy, n=43). The Kaplan-Meier method was used for survival analysis. Results In all patients, the median OS and PFS were 23.5 and 13.3 months respectively. SER was significantly correlated with OS and PFS (P=0.001; P=0.001). The median OS in patients undergoing radiotherapy after 2, 3, 4, 5, and 6 cycles of induction chemotherapy was 33.2, 26.7, 20.6, 16.9, and 17.9 months (P=0.000), respectively. The median OS time and 1-, 2-, and 5-year OS rates were 27.8 months, 87%, 62%, and 34%, respectively, in the early radiotherapy group, and 17.9 months, 74%, 37%, and 15%, respectively, in the late radiotherapy group (P=0.017). The median PFS time and 1-, 2-, and 5-year PFS rates were 17.1 months, 65%, 43%, and 28%, respectively, in the early radiotherapy group, and 11.9 months, 49%, 21%, and 14%, respectively, in the late radiotherapy group (P=0.022). Conclusions Shorter SER achieves better treatment outcomes in elderly patients with LS-SCLC undergoing sequential chemoradiotherapy. Early radiotherapy provides a survival benefit for patients. Key words: Lung neoplasms/radiotherapy; Lung neoplasms/chemotherapy; Prognosis