Receipt of thoracic radiation therapy and radiotherapy dose are correlated with outcomes in a retrospective study of three hundred and six patients with extensive stage small-cell lung cancer

• Published in: Radiotherapy and oncology 2017-11, Vol.125 (2), p.331-337
• Main Authors: Li-Ming, Xu, Zhao, Lu-jun, Simone, Charles B., Cheng, Chingyun, Kang, Minglei, Wang, Xin, Gong, Lin-Lin, Pang, Qing-Song, Wang, Jun, Yuan, Zhi-yong, Wang, Ping
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Dose Fractionation; Dose-Response Relationship, Radiation; Extensive stage; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Male; Middle Aged; Prognosis; Radiation dose; Radiotherapy, Conformal; Radiotherapy, Intensity-Modulated; Retrospective Studies; Small cell lung cancer; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - pathology; Small Cell Lung Carcinoma - radiotherapy; Thoracic radiation therapy; Young Adult
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2017.10.005

The importance of the thoracic radiation therapy (TRT) dose has not been clearly defined in extensive stage small-cell lung cancer (ES-SCLC) and it is unclear whether improved TRT dose translates into a survival benefit. 306 patients with ES-SCLC were retrospectively reviewed, of which 170 received IMRT/CRT fractionation RT after ChT, and 136 received chemotherapy (ChT) alone. We adopted the time-adjusted BED (tBED) for effective dose fractionation calculation. Due to the nonrandomized nature of this study, we compared the ChT+RT with ChT groups that matched on possible confounding variables. Patients achieved 2-year OS, PFS and LC rates of 19.7%, 10.7% and 28.4%, respectively. After propensity score matching, (113 cases for each group), the rates of OS, PFS and LC at 2 years were 21.4%, 7.7% and 34.5% for ChT+TRT, and 10.3% (p