93P - Chemoradiotherapy with radical intent for small cell lung cancer (SCLC): A 5 year retrospective review

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Cytotoxic agents
Small-Cell Lung Cancer
Surgical oncology
Therapy
Biological therapy
Radiation oncology
Presenter Emma Higgins
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors E. Higgins, G. Edwards, J. Tanguay, M. Button
  • Clinical Oncology, Velindre Cancer Centre Velindre Hospital, CF14 2TL - Cardiff/GB

Abstract

Background

Optimal therapy for radically treated SCLC is concurrent hyperfractionated chemoradiotherapy (CCRT-45 Gy/30fractions/3 weeks, 3-D conformal) and prophylactic cranial irradiation (after complete or a good partial response). CCRT is not always feasible; patients may then have sequential chemoradiotherapy (SCRT)-45 Gy/15 fractions/3 weeks, 2D or 3D planned.

Methods

CCRT and 3D planning were introduced locally in 2010. We reviewed all SCLC cases treated with both chemotherapy (CT) and radiotherapy (RT) with potentially curative intent between 2010 and 2014 at Velindre Cancer Centre.

Results

87 patients were treated. 86 received both CT and RT (73 sequential and 13 concurrent). One deteriorated after cycle 1 chemotherapy (further CT/RT cancelled). The median age was 66 (range 36–85). 51 were female, 36 were male. WHO PS at presentation: 0–36%, 1–43%, 2–18%, 3–2%. 70% had stage III disease. 44 patients had 2D RT planning; 42 patients had 3D; 3D planning increased over time. Only 15% received CCRT. 93PT1 Table: Treatment details CCRT/SCRT, 2010–2014

 Total2D planning3D planningCCRTSCRTMedian OS (months)
20102422202415
2011189941417
201213854925
201317 a41231325
201415114213n/a
Total8744421373 
a Includes 1 patient who did not proceed to RT.

Median overall survival (OS) for all patients was 18 months; 5 year survival 17%. Median OS was higher in those receiving CCRT vs SCRT (27 months vs 18months, p = 0.391). Interestingly 3D RT planning gave a median OS of 27 months vs 15months for 2D planning (p = 0.185). OS non-significantly improved over time. Neither stage nor PS affected survival significantly.

Conclusions

Our survival data is in keeping with published data. Where given, CCRT offered a survival benefit (may be due to selection bias in this non-randomised group). Disappointingly, we have not seen increasing use of CCRT, but this reflects treatment in a clinical population. Encouragingly, there was a non-significant trend to improved survival over time and with 3-D planning compared to 2-D. CCRT appears optimal, we suggest that radical RT for SCLC should be 3-D planned.

Clinical trial identification


Legal entity responsible for the study

Velindre Cancer Centre

Funding

Velindre Cancer Centre

Disclosure

All authors have declared no conflicts of interest.