Comparison Of Long Term Results Between Matched Chemoradiotherapy And Surgery For Limited Stage Small Cell Lung Cancer
Authors Chen M, Hu X, Bao Y, Wang J, Chen Y, Xu Y, Jin J, Chen M
Received 14 July 2019
Accepted for publication 12 October 2019
Published 23 October 2019 Volume 2019:11 Pages 9049—9055
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Sanjeev Srivastava
Meng-yuan Chen,1 Xiao Hu,1 Yong Bao,2 Jin Wang,1 Ya-mei Chen,1 Yu-jin Xu,1 Jianan Jin,1 Ming Chen1
1Department of Radiation Oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, People’s Republic of China; 2Department of Radiation Oncology, The First Affiliate Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, People’s Republic of China
Correspondence: Ming Chen
Department of Radiation Oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, No 1, East Banshan Road, Hangzhou, Zhejiang 310022, People’s Republic of China
Tel +86 571 8812 2222
Fax +86 571 8812 2508
Purpose: To compare the efficacy of chemoradiotherapy or surgery for limited-stage small cell lung cancer (SCLC).
Patients and methods: A retrospective analysis was performed on 138 patients with limited-stage SCLC who received surgery (69 patients) or chemoradiotherapy (69 patients) between January 2000 and September 2016 in Zhejiang Cancer Hospital. Patients of the chemoradiotherapy group were selected by using “pair-matched case-control” methodology from a cohort of 503 patients who received chemoradiotherapy.
Results: The major prognostic factors, including T, N stage, treatment duration, age, gender, and whether or not they received prophylactic cranial irradiation were well balanced between two groups. The median overall survival (OS) time and 5-year OS rate were 37.1 months and 45.0% in the surgical group vs 45.0 months and 45.0% in the chemoradiotherapy group (P=0.846). The median progression-free survival (PFS) time and 5-year PFS rate were 27.1 months and 37.8% vs 36.2 months and 40.0%, respectively, in the two groups (P=0.610). The 5-year OS rate (62.3% vs 40.1%, P=0.038) and 5-year PFS rate (80.1% vs 40.1%, P=0.048) in the surgical group were significantly higher than those of the chemoradiotherapy group in patients with stage I disease. The 5-year OS rate (41.2% vs 50.6%, P=0.946) and 5-year PFS rate (64.7% vs 42.1%, P=0.280) of surgery for stage II SCLC were comparable to chemoradiotherapy. As for stage III SCLC, compared with the surgical group, the chemoradiotherapy group had a better 5-year OS trend (25.1% vs 47.6%, P=0.220), but the difference did not reach statistical significance.
Conclusion: Surgery could confer survival benefits in patients with p-stage I disease, but not in patients with p-stage II and III disease.
Keywords: SCLC, survival, prognosis, lung cancer, surgery, chemoradiotherapy
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