Radiation dose escalation in limited-stage small-cell lung cancer

Int J Radiat Oncol Biol Phys. 2003 Nov 1;57(3):701-8. doi: 10.1016/s0360-3016(03)00715-6.

Abstract

Purpose: To review the treatment outcomes of limited-stage small-cell lung cancer (LS-SCLC) patients treated with > or =50 Gy of radiation at Massachusetts General Hospital (MGH) between 1987 and 2000 and to assess for evidence of a continuation of a radiation dose response.

Methods and materials: The MGH cancer registry was searched for SCLC patients treated with radiotherapy between 1987 and 2000. Records of LS-SCLC patients treated with curative intent and radiation doses > or =50 Gy at MGH were reviewed. Surgical patients were excluded.

Results: Eighty-four LS-SCLC patients were treated with radiotherapy at MGH between 1987 and 2000. Of the 84 patients, 54 (64%) met the inclusion criteria; 30 patients (56%) in this study died, and 4 (7%) were lost to follow-up. The median follow-up of the surviving patients was 42 months. The median overall survival was 29 months. The 2- and 5-year survival rate was 64% and 47%, respectively. The local control rate at 3 years was 78%.

Conclusion: The overall survival, local control, and disease-free survival rates for LS-SCLC patients treated with > or =50 Gy of radiation compare favorably with historical data. These findings suggest a continuation of the radiation dose-response curve in LS-SCLC. This further supports the need for appropriately powered, Phase III, prospective randomized trials in radiation dose escalation or radiation dose intensification for LS-SCLC.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Small Cell / mortality
  • Carcinoma, Small Cell / pathology
  • Carcinoma, Small Cell / radiotherapy*
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Radiation Injuries / etiology
  • Radiation Injuries / mortality
  • Radiotherapy Dosage
  • Treatment Failure