Abstract：Objective To evaluate the role of thoracic three-dimensional conformal radiotherapy (3DCRT) in patients with extensive-stage small cell lung cancer (ES-SCLC). Methods A total of 171 patients with ES-SCLC admitted from 2004 to 2009 were included in the study. Eighty-six patients received thoracic 3DCRT and systemic chemotherapy (CT), while 85 patients received systemic CT alone. 3DCRT was delivered at 1.5 Gy/fraction twice daily or 2.0 Gy/fraction once daily, with a total dose ranging from 40 to 62 Gy. The CT regimen consisted of carboplatin/cisplatin and etoposide. The survival time and survival rate were calculated by the Kaplan-Meier method, and the log-rank test was used for univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis. Results The follow-up rate was 100%. The median overall survival (OS) time and the 2- and 5-year OS rates were 15 months, 31.5%, and 2.4%, respectively, for all patients;they were 18 months, 35.3%, and 2.4%, respectively, for the CT/3DCRT group, versus 12 months, 14.5%, and 2.4% for the CT group (P=0.023). The median progression-free survival (PFS) time and the 1-and 2-year PFS rates were 8 months, 27.5%, and 2.4%, respectively, for all patients;they were 9 months, 35.4%, and 6.0%, respectively, for the CT/3DCRT group, versus 6 months, 20.5%, and 6.0% for the CT group (P=0.004). In the CT/3DCRT group, the 22 patients who received 45 Gy at 1.5 Gy/fraction twice daily had a median PFS time of 11 months, versus 9 months for the 26 patients who received 60 Gy at 2.0 Gy/fraction once daily (P=0.037). Multivariate analysis revealed that receiving ≥4 cycles of CT (P=0.001) and 3DCRT (P=0.008) were favorable prognostic factors for OS. Conclusions Thoracic 3DCRT can improve the OS and PFS in patients with ED-SCLC, and it has good efficacy when delivered with a total dose of 45 Gy at 1.5 Gy/fraction twice daily. Thoracic 3DCRT and receiving ≥4 cycles of CT are independent favorable prognostic factors for OS.
Luan Zupeng,Wang Zhiwu,Huang Wei et al. Role of thoracic conformal radiotherapy in patients with extensive-stage small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2014, 23(5): 401-405.
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