Objective: To evaluate the effect of comprehensive treatment and examine the impact of clinical factors on the survival outcome of limited-stage small cell lung cancer.
Methods: The clinical records of 335 patients with limited-stage small cell lung cancer treated in the Cancer Hospital of Chinese Academy of Medical Sciences between January 1996 and December 2006 were analyzed retrospectively in this study. Kaplan-Meier method was used for survival analysis, and log-rank test and Cox regression were used for univariate and multivariate analyses of prognostic factors.
Results: The median follow-up time was 54 months for all patients, the median survival time was 23.8 months, and progression-free survival was 12.5 months. The 2-, 3-, and 5-year overall survival rates were 47.3%, 32.9%, and 22.9%, respectively. The acute toxicity during comprehensive treatment was tolerable. The incidence of ≥grade 3 hematological toxicity, ≥grade 3 gastrointestinal toxicity, ≥grade 2 radiation pneumonitis and ≥grade 2 acute esophagitis were 37.0%, 14.9%, 11.0%, and 38.8%, respectively. The univariate analysis showed that KPS<80, smoking and high LDH level significantly reduced the overall survival time in patients with limited-stage SCLC. The multivariate analysis showed that KPS and weight loss were independent factors affecting the prognosis for the limited stage SCLC patients (P<0.05 for all).
Conclusions: Sequential chemoradiotherapy can be safely and effectively performed in limited-stage small cell lung cancer. Krnofsky performance status and weight loss are independent prognostic factors for the overall survival of LS-SCLC.