Treatment Outcomes of 9,994 Patients With Extensive-Disease Small-Cell Lung Cancer From a Retrospective Nationwide Population-Based Cohort in the Korean HIRA Database

Jung Soo Lee; Seoree Kim; Soo-Yoon Sung; Yeo Hyung Kim; Hyun Woo Lee; Ji Hyung Hong; Yoon Ho Ko

doi:10.3389/fonc.2021.546672

Treatment Outcomes of 9,994 Patients With Extensive-Disease Small-Cell Lung Cancer From a Retrospective Nationwide Population-Based Cohort in the Korean HIRA Database

Front Oncol. 2021 Mar 22:11:546672. doi: 10.3389/fonc.2021.546672. eCollection 2021.

Authors

Jung Soo Lee¹, Seoree Kim², Soo-Yoon Sung³, Yeo Hyung Kim¹, Hyun Woo Lee⁴, Ji Hyung Hong², Yoon Ho Ko^{2

5}

Affiliations

¹ Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
² Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
³ Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
⁴ Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea.
⁵ Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Abstract

To investigate the efficacy of irinotecan-based (IP) and etoposide-based (EP) platinum combinations, and of single-agent chemotherapy, for treatment of extensive-disease small cell lung cancer (ED-SCLC), we performed a large-scale, retrospective, nationwide, cohort study. The population data were extracted from the Health Insurance Review and Assessment Service of Korea database from January 1, 2008, to November 30, 2016. A total of 9,994 patients were allocated to ED-SCLC and analyzed in this study. The primary objectives were to evaluate the survival outcomes of systemic first-line treatments for ED-SCLC. For first-line treatment, patients who received IP showed a better time to first subsequent therapy (TFST) of 8.9 months (95% confidence interval [CI], 8.50-9.40) than those who received EP, who had a TFST of 6.8 months (95% CI, 6.77-6.97, P < 0.0001). In terms of overall survival (OS), IP was superior to EP (median OS, 10.8 months; 95% CI, 10.13-11.33 vs. 9.5 months; 95% CI, 9.33-9.73; P < 0.0001). Taken together, in the Korean population, first-line IP combination chemotherapy had significantly favorable effects on OS and TFST.

Keywords: efficacy; extensive-disease small cell lung cancer; population-based cohort study; prognosis; systemic chemotherapy.