Purpose: Retrospective analysis of 137 patients with limited stage small cell lung carcinoma who received radiotherapy between 1978 and 1990 and literature review.
Materials and methods: The population was divided into two groups according to the total dose of radiation delivered to the thorax: 45 Gy (1.8 Gy by fraction) or the equivalent irradiation dose administered by hypofractionation (group 1, 29 patients) and 65 Gy (1,8 Gy by fraction) or the equivalent irradiation dose administered by hypofractionation (group 2, 96 patients).
Results: The actuarial survival rate was 20% at 2 years and 9% at 5 years. It was 25% at 2 years and 17% at 5 years for 12 patients with surgical resection. For patients who did not undergo surgical resection, it was 20% at 2 years and 9% at 5 years for 96 patients belonging to group 2, while it was 14% at 2 years and 3.5% at 5 years for group 1. Deaths due to local relapse reached 48% in the group treated with 45 Gy and 33% in the group treated with 65 Gy (NS). For the 33 patients who were more than 70 years old at the time of treatment, the actuarial survival rate was 18% at 2 years and 6% at 5 years with death from other causes twice as high as that of patients who were less than 70 years old at the time of treatment. For the 59 patients who were less than 70 years old at the time of treatment, in whom supraclavicular node, pleural effusion or superior vena cava syndrome were not depicted and who were treated with the highest dose (4% of the total number of patients), the actuarial survival rate was 20% at 2 years and 14% at 5 years. Literature analysis shows that treatment of limited small cell lung cancer with chemotherapy and thoracic irradiation increased the overall survival rate from 16.5% to 23% at 2 years and the local control from 23% to 48%, in comparison with chemotherapy alone.
Conclusion: Although these results are modest, they seem to be improved with more effective chemotherapy, especially with the association of radiotherapy and concomitant chemotherapy.