[The effect of chemo-radiotherapy on the remission and survival in patients with limited stage small cell lung cancer]

Abstract

Introduction: The combined modality treatment used in case of limited stage small cell lung cancer assures the longest disease-free and average survival meanwhile maintaining an acceptable quality of life.

Object: The authors examined whether the combined modality treatment in case of limited-stage small cell lung cancer affects the remission positively or not: they presumed that the therapeutic response, early partial or complete clinical and oncological remission develops earlier than in patients treated with chemotherapy. The authors' other presumption was that the early therapeutic response could be the guarantee of the longest possible disease-free and average survival.

Patients and method: Small cell lung cancer (SCLC) was proved in 72 patients (23 women, 49 men, average 53 year-olds) with histological and/or cytological examination. Having examined which stage the patients were in, they proved to be in the limited stage. The patients were divided into two groups at random: cytotoxic chemotherapy containing cisplatin + etoposide was used in 36 cases, meanwhile in the other 36 cases the chemotherapy was completed with early concurrent thoracic radiotherapy.

Results: The therapeutic response happened earlier (early remission) in case of patients treated with chemo-radiotherapy than with chemotherapy treatment (average 10.4-12.6 weeks, SD = 1.22-1.99). The result of the "log rank" test showing the difference between the two groups is strongly significant in favor of the chemo-radiotherapy group (p = 0.0001). In patients with early remission receiving chemo-radiotherapy, the thoracic recidives and metastasis developed later (average 74.8 weeks, SD = 44.95), furthermore the average survival also proved to be longer (93.9 weeks, SD = 57.09). The average time until the development of tumor recidives and metastasis in patients belonging to the chemotherapy group was 44.5 weeks (SD = 30.23), and the average survival was 67.4 weeks (SD = 32.77). The result of the "log rank" test proved significant advantage for the chemo-radiotherapy group both for disease-free survival (p = 0.0010) and average survival (p = 0.0079 ). Another positive effect of chemo-radiotherapy was that less thoracic recidives and central nervous system metastasis could be diagnosed. Examination of treatment toxicity showed that one has to count primarily with esophagitis and pneumonitis related to the radiotherapy in patients receiving chemo-radiotherapy.