Thoracic radiation therapy improves the overall survival of patients with extensive-stage small cell lung cancer with distant metastasis

BACKGROUND: The authors conducted a retrospective study to evaluate the effects of thoracic radiation therapy (TRT) for patients with extensive-stage small cell lung cancer (ED-SCLC). METHODS: Between January 2003 and December 2006, the records of 119 patients who were diagnosed with ED-SCLC (all with distant metastasis [M1]) were included in the study. Sixty patients received chemotherapy (ChT) and TRT (ChT/TRT), and 59 patients received ChT alone. The ChT regimens consisted of either carboplatin and etoposide (CE) or cisplatin and etoposide (PE). The total dose of TRT ranged from 40 to 60 grays (Gy) at 1.8 to 2.0 Gy per fraction. RESULTS: For the entire group, the median survival was 13 months, and the 2-year and 5-year overall survival (OS) rates were 26.1% and 6.5%, respectively. The median survival and the 2-year and 5-year OS rates were 17 months, 35%, and 7.1%, respectively, in the ChT/TRT group and 9.3 months, 17%, and 5.1%, respectively, in the ChT group (P=.014). However, this improvement was achieved at the expense of low toxicity. Multivariate analysis revealed that receiving >= 4 cycles of ChT (P=.032) and TRT (P=.005) were favorable prognostic factors for OS. Of all toxicities, only high-grade leucopenia (grade >3) was more frequent in the ChT/TRT group. CONCLUSIONS: The addition of TRT to ChT improved the OS of patients with ED-SCLC. Furthermore, receiving >= 4 cycles of ChT and TRT were independent, favorable prognostic factors for OS. Cancer 2011; 117: 5423-31. (C) 2011 American Cancer Society.