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- Publisher Website: 10.1097/JTO.0b013e318293d8a4
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- PMID: 23715301
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Article: A pooled analysis of limited-stage small-cell lung cancer patients treated with induction chemotherapy followed by concurrent platinum-based chemotherapy and 70 Gy daily radiotherapy: CALGB 30904
Title | A pooled analysis of limited-stage small-cell lung cancer patients treated with induction chemotherapy followed by concurrent platinum-based chemotherapy and 70 Gy daily radiotherapy: CALGB 30904 |
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Authors | |
Keywords | Chemoradiotherapy Dosage-escalated radiotherapy Limited-stage small-cell lung cancer |
Issue Date | 2013 |
Citation | Journal of Thoracic Oncology, 2013, v. 8 n. 8, p. 1043-1049 How to Cite? |
Abstract | INTRODUCTION: Standard therapy for limited-stage small-cell lung cancer (L-SCLC) is concurrent chemotherapy and radiotherapy (RT) followed by prophylactic cranial radiotherapy. Although many consider the standard RT regimen to be 45 Gy in 1.5 Gy twice-daily fractions, this has failed to gain widespread acceptance. We pooled data of patients assigned to receive daily RT of 70 Gy from three, consecutive prospective Cancer and Leukemia Group B L-SCLC cancer trials and report the results here. METHODS: All patients from consecutive Cancer and Leukemia Group B L-SCLC trials (39808, 30002, and 30206) using high-dosage daily RT with concurrent chemotherapy were included, and analyzed for toxicity, disease control, and survival. Overall survival (OS) and progression-free survival (PFS) were modeled using Cox proportional hazards models. Prognostic variables for OS-rate and PFS-rate were assessed using logistic regression model. RESULTS: Two hundred patients were included. The median follow-up was 78 months. Grade 3 or greater esophagitis was 23%. The median OS for pooled population was 19.9 months (95% confidence interval [CI]: 16.7-22.3), and 5-year OS rate was 20% (95% CI: 16-27%). The 2-year PFS was 26% (95% CI: 21-32%). Multivariate analysis found younger age (p = 0.02; hazard ratio [HR]: 1.023; 95% CI: 21-32), and female sex (p = 0.02; HR:0.69; 95% CI: 0.50-0.94) independently associated with improved overall survival. CONCLUSION: Two-Gy daily RT to a total dosage of 70 Gy was well tolerated with similar survival to 45 Gy (1.5 Gy twice-daily). This experience may aid practitioners decide whether high-dosage daily RT with platinum-based chemotherapy is appropriate outside of a clinical trial. © 2013 by the International Association for the Study of Lung Cancer. |
Persistent Identifier | http://hdl.handle.net/10722/194516 |
ISSN | 2023 Impact Factor: 21.0 2023 SCImago Journal Rankings: 7.879 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Salama, JK | - |
dc.contributor.author | Hodgson, L | - |
dc.contributor.author | Pang, H | - |
dc.contributor.author | Urbanic, JJ | - |
dc.contributor.author | Blackstock, AW | - |
dc.contributor.author | Schild, SE | - |
dc.contributor.author | Crawford, J | - |
dc.contributor.author | Bogart, JA | - |
dc.contributor.author | Vokes, EE | - |
dc.date.accessioned | 2014-01-30T03:32:41Z | - |
dc.date.available | 2014-01-30T03:32:41Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | Journal of Thoracic Oncology, 2013, v. 8 n. 8, p. 1043-1049 | - |
dc.identifier.issn | 1556-0864 | - |
dc.identifier.uri | http://hdl.handle.net/10722/194516 | - |
dc.description.abstract | INTRODUCTION: Standard therapy for limited-stage small-cell lung cancer (L-SCLC) is concurrent chemotherapy and radiotherapy (RT) followed by prophylactic cranial radiotherapy. Although many consider the standard RT regimen to be 45 Gy in 1.5 Gy twice-daily fractions, this has failed to gain widespread acceptance. We pooled data of patients assigned to receive daily RT of 70 Gy from three, consecutive prospective Cancer and Leukemia Group B L-SCLC cancer trials and report the results here. METHODS: All patients from consecutive Cancer and Leukemia Group B L-SCLC trials (39808, 30002, and 30206) using high-dosage daily RT with concurrent chemotherapy were included, and analyzed for toxicity, disease control, and survival. Overall survival (OS) and progression-free survival (PFS) were modeled using Cox proportional hazards models. Prognostic variables for OS-rate and PFS-rate were assessed using logistic regression model. RESULTS: Two hundred patients were included. The median follow-up was 78 months. Grade 3 or greater esophagitis was 23%. The median OS for pooled population was 19.9 months (95% confidence interval [CI]: 16.7-22.3), and 5-year OS rate was 20% (95% CI: 16-27%). The 2-year PFS was 26% (95% CI: 21-32%). Multivariate analysis found younger age (p = 0.02; hazard ratio [HR]: 1.023; 95% CI: 21-32), and female sex (p = 0.02; HR:0.69; 95% CI: 0.50-0.94) independently associated with improved overall survival. CONCLUSION: Two-Gy daily RT to a total dosage of 70 Gy was well tolerated with similar survival to 45 Gy (1.5 Gy twice-daily). This experience may aid practitioners decide whether high-dosage daily RT with platinum-based chemotherapy is appropriate outside of a clinical trial. © 2013 by the International Association for the Study of Lung Cancer. | - |
dc.language | eng | - |
dc.relation.ispartof | Journal of Thoracic Oncology | - |
dc.subject | Chemoradiotherapy | - |
dc.subject | Dosage-escalated radiotherapy | - |
dc.subject | Limited-stage small-cell lung cancer | - |
dc.title | A pooled analysis of limited-stage small-cell lung cancer patients treated with induction chemotherapy followed by concurrent platinum-based chemotherapy and 70 Gy daily radiotherapy: CALGB 30904 | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1097/JTO.0b013e318293d8a4 | - |
dc.identifier.pmid | 23715301 | - |
dc.identifier.scopus | eid_2-s2.0-84880923414 | - |
dc.identifier.volume | 8 | - |
dc.identifier.issue | 8 | - |
dc.identifier.spage | 1043 | - |
dc.identifier.epage | 1049 | - |
dc.identifier.isi | WOS:000322334300015 | - |
dc.identifier.issnl | 1556-0864 | - |