Abstract | INTRODUCTION: METHODS: Between 2003 and 2009, 23 patients with stage IV SCLC were treated with chemotherapy alone (no surgery or RT) and had computed tomography scans pre- and post two cycles of platin-based chemotherapy. Simulated RT plans were created as if to deliver 45 Gy to the thoracic disease. The percent of lung receiving ≥20 Gy (V20), mean lung dose, and normal tissue complication probability (NTCP) was evaluated in patients who had a partial response (≥30% volumetric reduction) in gross tumor volume. RESULTS: One (4.3%) patient had a complete response, 18 (78.3%) had a partial response, and four (17.4%) had stable disease. Among 18 responders, the absolute decrease in V20 was 7.4% (p < 0.01), in mean lung dose was 3.3 Gy (p < 0.01), and in NTCP was 5.5% (p < 0.01). Patients with a prechemotherapy V20 ≥35% versus V20 less than 35% had an average absolute reduction in NTCP of 10% versus 2% (p < 0.01). CONCLUSION: Patients with limited stage SCLC with a V20 ≥35% may benefit from induction chemotherapy as there is an estimated reduction of RP of 10%. This reduction in risk of RP after induction chemotherapy should be weighed against risks and benefits of delaying upfront RT.
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Authors | Neha P Amin, Moyed Miften, Brian Kavanagh, David Raben, D Ross Camidge, Dale Thornton, Nicole Rochford, Laurie E Gaspar |
Journal | Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
(J Thorac Oncol)
Vol. 6
Issue 9
Pg. 1553-62
(Sep 2011)
ISSN: 1556-1380 [Electronic] United States |
PMID | 21642862
(Publication Type: Journal Article)
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Chemical References |
- Etoposide
- Irinotecan
- Carboplatin
- Paclitaxel
- Cisplatin
- Camptothecin
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Topics |
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects)
- Camptothecin
(administration & dosage, analogs & derivatives)
- Carboplatin
(administration & dosage)
- Cisplatin
(administration & dosage)
- Combined Modality Therapy
- Etoposide
(administration & dosage)
- Female
- Follow-Up Studies
- Humans
- Induction Chemotherapy
(adverse effects)
- Irinotecan
- Lung Neoplasms
(complications, drug therapy, radiotherapy)
- Male
- Middle Aged
- Neoplasm Staging
- Paclitaxel
(administration & dosage)
- Radiation Pneumonitis
(etiology)
- Radiotherapy, Conformal
- Retrospective Studies
- Risk Assessment
- Small Cell Lung Carcinoma
(complications, drug therapy, radiotherapy)
- Survival Rate
- Tomography, X-Ray Computed
- Treatment Outcome
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