Survival of patients treated with radiation for small-cell lung cancer in the Hospital of the Ministry of Interior with Warmia and Mazury Oncology Center in Olsztyn between 2003 and 2006
Abstract
Introduction. Small-cell lung cancer (SCLC) is one of the cancers with the worst prognosis because of its fast growth and early metastases. The aim of this study was the estimation of treatment effectiveness of patients treated with small-cell lung cancer in the Hospital of the Ministry of Interior with Warmia and Mazury Oncology Center in Olsztyn between 2003 and 2006 (the initial 4 years of Centre activity).
Material and methods. The analysis included all patients (202) treated with radiation for SCLC between 2003 and 2006. Patients in this group (both limited disease-LD and extensive disease-ED) were treated with radical or palliative radiotherapy. The Kaplan-Meier method was used to estimate overall survival. Differences in survival of subgroups were evaluated using the log-rank test. Results have limited value due to retrospective analysis.
Results. Overall 2- and 5-year overall survival (OS) of all 202 patients was respectively 25% and 10% (median 11 months). 2- and 5-year OS of patients with LD SCLC was respectively 36% and 15% (median 17 months). None of the patients with ED SCLC survived 5 years but one patient survived 2 years (median 3.3 months). 2- and 5-year OS of patients who received concurrent and sequential chemoradiotherapy was 44% vs 31% and 17% vs 16% (p = 0.38). 2- and 5-year OS of patients treated radically, who began radiotherapy with 1 or 2 cycle of chemotherapy, with 3–6 cycle ofchemotherapy or after chemotherapy was 48% vs 42% vs 31% and 24% vs 14% vs 16% (differences between groups were not statistically significant). There were no differences between 2- and 5-year OS of patients treated with radiation administered twice daily and once daily (p = 0.87). Survival of women was better than men. 2- and 5-year OS of women was appropriately 54% and 24% and OS of men was 32% and 13% (p = 0.016). 2- and 5-year OS of patients treated radically, who received PCI was 58% and 18% and OS of patients who did not receive PCI was 21% and 12%(p = 0.00004).
Conclusions. Survival of patients (LD SCLC) who received concurrent chemoradiotherapy was statistically better than patients who received sequential chemoradiotherapy (statistically non-significant). There was a tendency towards better survival if radiotherapy was given with initial cycles of chemotherapy. These results of treatment in the Hospital of the Ministry of Interior with Warmia and Mazury Oncology Center in Olsztyn which were obtained during the initial four years of Centre activity did not differ from published results of clinical trials.