58P - Radiation therapy (RT) in the palliative treatment of metastatic small cell lung cancer (SCLC)

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Small-Cell Lung Cancer
Palliative Care
Surgery and/or Radiotherapy of Cancer
Presenter Yury Ragulin
Citation Annals of Oncology (2015) 26 (suppl_1): 17-17. 10.1093/annonc/mdv047
Authors Y. Ragulin1, I. Ivanova2, I. Gulidov2, Y. Mardynsky2, A. Zolotkov2, D. Gogolin2, L. Kursova2
  • 1Thoracic Department, Medical Radiological Research Center, 249036 - Obninsk/RU
  • 2Radiology, Medical Radiological Research Center, 249036 - Obninsk/RU

Abstract

Aim/Background

There are some data on the use of different regimens for unconventional fractionation of palliative RT in SCLC patients. The aim of this study was comparative evaluation of the effectiveness of palliative RT in patients (pts) with metastatic SCLC carried out by the method of accelerated hyperfractionated and hypofractionated RT.

Methods

Between 1997 and 2010 in MRRC clinic 108 pts with stage IV SCLC were treated. Radiotherapy to the primary site was performed as follows: Group 1 (39 pts) - accelerated hyperfractionated with uneven crushing daily dose of 1.5 Gy and 1 Gy with 5 - 6 hours interval, total dose 45 - 50 Gy. Group 2 (35 pts) - daily dose 3 Gy to a total dose 39 - 42 Gy. Group 3 (34 pts) received palliative RT only for bone metastases of 8 Gy single dose. Pts 1 and 2 groups received palliative RT to the tumor in the lung and intrathoracic lymph nodes, some of them subsequently being symptomatic RT metastases in different organs. Pts 3 group received only symptomatic courses RT on bone metastases. Concomitantly with RT all pts received chemotherapy (cisplatin and etoposide).

Results

In group 1 the effect of chemoradiation was obtained in 87.2% cases (decrease tumor size by 50% or more). In group 2 effect was in 77.1% of cases. Analgesic effect of the treatment in group 3 was achieved in 58.8% of cases. Grade I esophagitis was diagnosed in 29 pts 1 group (74.4%) and 27 pts (77.1%) – 2 group. Grade I - II pneumonitis was observed in 15.4% pts of group 1 and 22.9% pts - 2 groups. Median survival in the 1 group was 13 months, in the 2 and 3 groups - 9 months. One year survival - 53.8% in group 1, 40% in group 2 and 29.4% in group 3. Patients who received palliative course of RT in accelerated hyperfractionated regimens on the primary tumor lived a relatively long patients treated with symptomatic RT on bone metastases.

Conclusions

Irradiation of primary intrathoracic tumors in hyperfractionated accelerated regimen for patients with SCLC stage IV allows significantly increase overall survival compared to chemotherapy in combination with RT only for distant metastases. RT by this method for palliation improves the efficiency of the treatment of advanced SCLC, well tolerated, reduces the total time of treatment, and does not require additional material costs.

Disclosure

All authors have declared no conflicts of interest.