TREATMENT OUTCOME IN PATENTS WITH LIMITED STAGE SMALL CELL CANCER AND THE ROLE OF RADIATION THERAPY

We retrospectively analyzed the records of 178 patients with limited stage small-cell lung cancer treated at our institute between 1990-1997. Fifty six patients (31 %) were treated only by chemotherapy and 122 patients (69%) by combined chemotherapy and radiotherapy. Chemotherapy was cisplatin based, the most frequent regimen being cisplatin and etoposide with a median cycle of 6. Median radiation therapy dose was 39 Gy (13x300 cGy). In 63 patients (52%) radiotherapy was delivered during or after 3 cycles of chemotherapy and in 59 patients (48%) during or after 4 cycles of chemotherapy. Median follow-up was 12.2 months (range 4-73 months). Median and overall survival at 2 years were 13 months and 21% respectively in chemotherapy group; and 18 months and 34% respectively in the combined chemotherapy and radiotherapy group (P=0.009). The median and overall survival at 2 years were 12 months and 14% respectively in the patients who received radiotherapy during or after 3 cycles of chemotherapy; and 18 "months and 31% respectively in the patients who received radiotherapy during or after 4 or more cycles of chemotherapy (P=0.0011). As a result, the combined chemotherapy and radiotherapy significantly improves the overall survival in limited stage small cell lung cancer but the timing of radiotherapy has conflincting results.