open access

Vol 14, No 2 (2009)
Untitled
Published online: 2009-03-01
Submitted: 2009-01-29
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Isolated nodal failure after chemo-radiotherapy in limited disease small cell lung cancer (LD-SCLC)

Marek WIERZCHOWSKI, Arkadiusz SPRAWKA, Lucyna KĘPKA
DOI: 10.1016/S1507-1367(10)60023-5
·
Rep Pract Oncol Radiother 2009;14(2):58-63.

open access

Vol 14, No 2 (2009)
Untitled
Published online: 2009-03-01
Submitted: 2009-01-29

Abstract

Background

The irradiation volume for treatment of limited disease small cell lung cancer (LD-SCLC), are still controversial. One of the aspects of radiation volume is the use of elective nodal irradiation (ENI), which has never been subjected to randomized study in SCLC patients.

Aim

To review retrospectively patterns of failure in relation to the radiation field after chemoradiotherapy (CHT-RT) in patients with limited disease small cell lung cancer (LD-SCLC).

Material and Methods

Between 1997 and 2006, 117 consecutive patients with LD-SCLC received chemotherapy with sequential radiotherapy (70%) and concurrent or alternating CHT-RT (30%). All but one case had predefined elective nodal irradiation (ENI) without inclusion of supraclavicular regions. Prophylactic cranial irradiation (PCI) was administered to 39% of patients.

Results

The median follow-up for the 20 living patients was 33 months. The overall survival at 2 years was 36% (median survival: 18 months). In-field locoregional progression was observed in 42 patients (36%). Distant metastases occurred in 71 patients (61%). Five patients (4%) developed isolated nodal failure (INF) without local progression in the supraclavicular region. Patients with INF had N3 disease more often than those without INF (60% vs 21%, p = 0.04). There was 5% RTOG grade 3 or higher early radiation toxicity.

Conclusions

INF failures are rare; however, the need for extension of ENI to supraclavicular areas may be reconsidered in N3 patients.

Abstract

Background

The irradiation volume for treatment of limited disease small cell lung cancer (LD-SCLC), are still controversial. One of the aspects of radiation volume is the use of elective nodal irradiation (ENI), which has never been subjected to randomized study in SCLC patients.

Aim

To review retrospectively patterns of failure in relation to the radiation field after chemoradiotherapy (CHT-RT) in patients with limited disease small cell lung cancer (LD-SCLC).

Material and Methods

Between 1997 and 2006, 117 consecutive patients with LD-SCLC received chemotherapy with sequential radiotherapy (70%) and concurrent or alternating CHT-RT (30%). All but one case had predefined elective nodal irradiation (ENI) without inclusion of supraclavicular regions. Prophylactic cranial irradiation (PCI) was administered to 39% of patients.

Results

The median follow-up for the 20 living patients was 33 months. The overall survival at 2 years was 36% (median survival: 18 months). In-field locoregional progression was observed in 42 patients (36%). Distant metastases occurred in 71 patients (61%). Five patients (4%) developed isolated nodal failure (INF) without local progression in the supraclavicular region. Patients with INF had N3 disease more often than those without INF (60% vs 21%, p = 0.04). There was 5% RTOG grade 3 or higher early radiation toxicity.

Conclusions

INF failures are rare; however, the need for extension of ENI to supraclavicular areas may be reconsidered in N3 patients.

Get Citation

Keywords

small-cell lung cancer; limited disease; radiotherapy; elective nodal irradiation; isolated nodal failure

About this article
Title

Isolated nodal failure after chemo-radiotherapy in limited disease small cell lung cancer (LD-SCLC)

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 14, No 2 (2009)

Pages

58-63

Published online

2009-03-01

DOI

10.1016/S1507-1367(10)60023-5

Bibliographic record

Rep Pract Oncol Radiother 2009;14(2):58-63.

Keywords

small-cell lung cancer
limited disease
radiotherapy
elective nodal irradiation
isolated nodal failure

Authors

Marek WIERZCHOWSKI
Arkadiusz SPRAWKA
Lucyna KĘPKA

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