Background & objective: Limited small cell lung cancer (SCLC) is sensitive to both radiotherapy and chemotherapy. Radiotherapy can enhance survival rate and reduce the local/regional recurrence rate of limited SCLC. This study was to analyze the efficacy of chemotherapy combined hyperfractionated accelerated radiotherapy (HART) on limited SCLC, observe treatment-related adverse events and summarize the treatment failure patterns.
Methods: A total of 55 limited SCLC patients were treated with EP regimen as induction chemotherapy, then received radiotherapy, followed with EP regimen as consolidation chemotherapy. Prophylactic cranial irradiation (PCI) was given to those patients who had achieved complete remission (CR) after chemoradiotherapy. As treatment was completed, patients were followed up, the efficacy and toxicities were evaluated.
Results: At the end of chemoradiotherapy, the overall response rate was 87.3%. The 1-, 3-, and 5-year overall survival rates were 79.1%, 40.3% and 16.1%, respectively, with the median survival time of 18.7 months. Grade III and IV hematologic toxicities were observed in 23 (41.8%) and 16 (29.1%) patients, respectively. Grade I and II radiation-induced pneumonitis occurred in 21 (38.2%) and 2 (3.6%) patients, respectively. Grade I and II radiation-induced esophagitis occurred in 29 (52.7%) and 12 (21.8%) patients, respectively. No grade III/IV non-hematologic toxicity was observed. Grade I and II pulmonary fibrosis occurred in 11 (20.0%) and 5 (9.1%) patients, respectively. Grade I esophageal stricture was observed in 2 (3.6%) patients. Of the 55 patients, 16 (29.1%) had local/regional recurrence, 21 (38.2%) suffered from distant metastasis.
Conclusions: The toxicities of EP regimen chemotherapy combined with HART are mild to moderate and are tolerable by patients. Local/regional recurrence and distant metastasis are the main reasons of treatment failure.