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Impact of the number of chemotherapy cycle of concurrent chemotherapy during radiotherapy on clinical prognosis of limited-stage small cell lung cancer
Ge Xingping1, Yu Hao2, Zhang Jiaqi2, Zhang Zhen2, Wang Youyou3, Wang Peng4, Xu Liming2, Liu Ningbo2, Zhao Lujun2
1Department of Radiotherapy, Yantaishan Hospital, Yantai 264003, China; 2Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key laboratory of Cancer Prevention and Therapy, Tianjin′s Clinical Research Center for Cancer, Tianjin 300060, China; 3Tianjin First Central Hospital, Tianjin 300192, China; 4Peking University International Hospital, Beijing 102206, China
AbstractObjective To investigate the role of concurrent chemoradiotherapy in the treatment of limited-stage small cell lung cancer (LS-SCLC) and the impact of the number of chemotherapy cycle during radiotherapy (RT) on clinical prognosis. Methods Patients with LS-SCLC treated with definitive radiotherapy from May, 2008 to September, 2016 were included in the study. The primary endpoint was overall survival (OS), which was calculated from the start of treatment to the date of death or last follow-up. The effect of the number of concurrent chemotherapy cycle and other clinical factors on clinical efficacy was analyzed. Survival analysis was performed with Kaplan-Meier method, and multivariate analysis was performed with Cox regression model. Results Three hundred and seventeen patients were eligible for the analysis. Among them, 129 patients received sequential chemoradiotherapy and 188 patients received concurrent chemoradiotherapy. Among patients receiving concurrent chemoradiotherapy, 86 patients received 1 cycle of concurrent chemotherapy and 102 cases of 2 cycles of concurrent chemotherapy. The median follow-up time was 22.47 months. Multivariate survival analysis showed that only clinical stage, timing of RT administration and prophylactic cranial irradiation (PCI) were the independent prognostic factor for OS. The median OS in patients who received 1 cycle and 2 cycles of concurrent chemotherapy during RT were 33.8 months and 30.4 months (P=0.400). No matter in elder patients or in younger patients, in early RT group or in late RT group and application of PCI or not, the number of concurrent chemotherapy cycle exerted no significant impact on OS. The incidence of grade 3 or above adverse events was 20% in the 1-cycle concurrent chemotherapy group, and 13.7% in the 2-cycle concurrent chemotherapy group. Conclusions Concurrent chemoradiotherapy is the standard treatment of LS-SCLC. Two cycles of concurrent chemotherapy during RT is not necessarily superior to 1 cycle of concurrent chemotherapy. The optimal number of concurrent chemotherapy cycle during RT need to be studied in a large prospective randomized clinical trial.
About author:: Ge Xingping and Yu Hao contributed equally to this article
Cite this article:
Ge Xingping,Yu Hao,Zhang Jiaqi et al. Impact of the number of chemotherapy cycle of concurrent chemotherapy during radiotherapy on clinical prognosis of limited-stage small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(7): 671-675.
Ge Xingping,Yu Hao,Zhang Jiaqi et al. Impact of the number of chemotherapy cycle of concurrent chemotherapy during radiotherapy on clinical prognosis of limited-stage small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(7): 671-675.
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2021, Vol. 30 
