1. Therapeutic Patterns and Clinical Outcomes in Limited Disease Small Cell Lung Cancer: A Decade of Analysis at a Tertiary Cancer Center.
- Author
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Ziegler, David Alexander, Cleve, Cecilia Christiane, Ziegler, Sonia, Schirmer, Markus Anton, Fischer, Laura Anna, Bohnenberger, Hanibal, Overbeck, Tobias Raphael, Braulke, Friederike, Hammerstein-Equord, Alexander von, Leu, Martin, Guhlich, Manuel, Dröge, Leif Hendrik, Rieken, Stefan, Rittmeyer, Achim, and El Shafie, Rami A.
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THERAPEUTIC use of antineoplastic agents , *RADIOTHERAPY , *CISPLATIN , *SEX distribution , *TREATMENT effectiveness , *TERTIARY care , *RETROSPECTIVE studies , *CANCER patients , *CARBOPLATIN , *DESCRIPTIVE statistics , *METASTASIS , *CANCER chemotherapy , *LONGITUDINAL method , *ETOPOSIDE , *LUNG tumors , *SMALL cell carcinoma , *PROGRESSION-free survival , *INDIVIDUALIZED medicine , *BRAIN tumors , *OVERALL survival , *HEALTH care teams , *MIDDLE age , *OLD age - Abstract
Simple Summary: The evaluation of therapeutic approaches over a decade at a tertiary cancer center in Germany was undertaken due to the frequent and critical discussions surrounding the selection of chemotherapy regimens and the incorporation of prophylactic cranial irradiation (PCI) in the management of limited disease small cell lung cancer (LD-SCLC). We found significant differences in progression-free survival (PFS) and overall survival (OS) between patients treated with carboplatin and etoposide (CP) and those treated with cisplatin and etoposide (EP), with EP showing better outcomes. Concomitant chemotherapy was also associated with improved PFS and OS. Notably, PCI was found to significantly improve OS and showed a trend towards improved PFS. Female patients had better OS, and the type of chemotherapy and PCI remained independent predictors of survival. This research provides valuable insights into treatment patterns, outcomes, and survival predictors for LD-SCLC, emphasizing the importance of personalized treatment approaches and the potential benefits of PCI. However, the study's retrospective nature and sample-size limitations should be considered, highlighting the need for further prospective studies in this field. In this study, we investigated the outcomes and factors influencing treatment efficacy in 93 patients with limited disease small cell lung cancer (LD-SCLC), with a median age of 64 years. We focused on the impact of chemotherapy regimens, prophylactic cranial irradiation (PCI), and patient-related variables. The median follow-up for OS was 17.3 months. We observed a statistically significant difference in PFS between LD-SCLC patients treated with cisplatin and etoposide (EP) and those treated with carboplatin and etoposide (CP) (PFS: EP 13.63 months vs. CP 6.54 months, p < 0.01). Patients treated with EP had better overall survival (OS) than CP-treated patients (OS: EP 26.9 months vs. CP 16.16 months, p < 0.01). Concomitant chemotherapy was associated with improved PFS (p = 0.003) and OS (p = 0.002). Patients receiving PCI showed superior OS (p = 0.05) and a trend towards improved PFS (p = 0.057). Female gender was associated with better OS (p = 0.025). Most patients had an ECOG performance status of 0 (71%). This real-world study underscores the importance of multidisciplinary LD-SCLC management, emphasizing the roles of chemotherapy, radiotherapy, and PCI. These findings inform personalized treatment strategies and emphasize the need for prospective trials to validate these results and optimize LD-SCLC treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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