1. Evaluation of the efficacy of cisplatin–etoposide and the role of thoracic radiotherapy and prophylactic cranial irradiation in LCNEC
- Author
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Gabriella Del Bene, Sara Elena Rebuzzi, Alessandra Anna Prete, Julio Rodrigo Giròn Berrìos, Daniele Rossini, Lucilla De Filippis, Flavia Longo, Carla Ferrara, Silvia Pecorari, Alessandra Emiliani, G. Manna, and Arsela Prelaj
- Subjects
0301 basic medicine ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Thoracic radiotherapy ,lcsh:Medicine ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Stage (cooking) ,Lung cancer ,Chemotherapy ,business.industry ,lcsh:R ,Original Articles ,medicine.disease ,respiratory tract diseases ,Surgery ,Radiation therapy ,030104 developmental biology ,030220 oncology & carcinogenesis ,Conventional PCI ,Cisplatin/etoposide ,Prophylactic cranial irradiation ,business - Abstract
In small-cell lung cancer (SCLC), the role of chemotherapy and radiotherapy is well established. Large-cell neuroendocrine carcinoma (LCNEC) shares several clinicopathological features with SCLC, but its optimal therapy is not defined. We evaluated clinical response and survival outcomes of advanced LCNEC treated in first-line therapy compared with SCLC. 72 patients with stage III–IV LCNEC (n=28) and extensive-stage SCLC (ES-SCLC) (n=44) received cisplatin–etoposide with/without thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI). Comparing LCNEC with SCLC, we observed similar response rates (64.2% versus 59.1%), disease control rates (82.1% versus 88.6%), progression-free survival (mPFS) (7.4 versus 6.1 months) and overall survival (mOS) (10.4 versus 10.9 months). TRT and PCI in both histologies showed a benefit in mOS (34 versus 7.8 months and 34 versus 8.6 months, both p=0.0001). LCNEC patients receiving TRT showed an improvement in mPFS and mOS (12.5 versus 5 months, p=0.02 and 28.3 versus 5 months, p=0.004), similarly to ES-SCLC. PCI in LCNEC showed an increase in mPFS (20.5 versus 6.4 months, p=0.09) and mOS (33.4 versus 8.6 months, p=0.05), as in ES-SCLC. Advanced LCNEC treated with SCLC first-line therapy has a similar clinical response and survival outcomes to ES-SCLC., Cisplatin–etoposide is an efficient treatment for large-cell neuroendocrine carcinoma. RT and PCI improve survival. http://ow.ly/sBJo309HG8s
- Published
- 2017