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The effect of bioequivalent radiation dose on survival of patients with limited-stage small-cell lung cancer.

Xia B, Chen GY, Cai XW, Zhao JD, Yang HJ, Fan M, Zhao KL, Fu XL - Radiat Oncol (2011)

Bottom Line: Outcomes of the two groups were compared.Patients in high BED group had a significantly better local control (p = 0.024), progression-free survival (p = 0.006) and overall survival (p = 0.005), with a trend toward improved distant-metastasis free survival (p = 0.196).Multivariable Cox regression demonstrated that age (p = 0.003), KPS (p = 0.009), weight loss (p = 0.023), and BED (p = 0.004) were significant predictors of overall survival.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

ABSTRACT

Background: To investigate the biological radiation dose-response for patients of limited-stage small-cell lung cancer (LS-SCLC) treated with high radiation dose.

Methods: Two hundred and five patients of LS-SCLC treated with sequential chemotherapy and thoracic radiotherapy with involved-field between 1997 and 2006 were reviewed retrospectively. Biologically effective dose (BED) was calculated for dose homogenization and was corrected with the factor of overall radiation time. Patients were divided into low BED group (n = 70) and high BED group (n = 135) with a cut-off of BED 57 Gy (equivalent to 60 Gy in 30 fractions over 40 days). Outcomes of the two groups were compared.

Results: Median follow-up was 20.7 months for all analyzable patients and 50.8 months for surviving patients. Considering all patients, median survival was 22.9 months (95% confidence interval, 20.6-25.2 months); 2- and 5-year survival rates were 47.2% and 22.3%, respectively. Patients in high BED group had a significantly better local control (p = 0.024), progression-free survival (p = 0.006) and overall survival (p = 0.005), with a trend toward improved distant-metastasis free survival (p = 0.196). Multivariable Cox regression demonstrated that age (p = 0.003), KPS (p = 0.009), weight loss (p = 0.023), and BED (p = 0.004) were significant predictors of overall survival.

Conclusions: Our data showed that a high BED was significantly associated with favourable outcomes in the Chinese LS-SCLC population, indicating that a positive BED-response relationship still existed even in a relatively high radiation dose range.

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Related in: MedlinePlus

Curves for overall survival (a) and progression-free survival (b). Comparison between biologically effective dose (BED) > 57 Gy and BED ≤ 57 Gy groups for patients with limited-stage small-cell lung cancer, both favouring the BED > 57G group.
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Figure 1: Curves for overall survival (a) and progression-free survival (b). Comparison between biologically effective dose (BED) > 57 Gy and BED ≤ 57 Gy groups for patients with limited-stage small-cell lung cancer, both favouring the BED > 57G group.

Mentions: The median OS for patients treated with low BED and those with high BED were 16.4 months (95% CI, 10.9-21.9 months) and 25.4 months (95%CI, 21.9-29.0 months); 2- and 5-year OS were 31.5% and 14.6%, 55.2% and 26.2%, respectively (p = 0.005, Figure 1a). The probability of PFS was significantly higher in high BED group than in low BED group (p = 0.006, Figure 1b).


The effect of bioequivalent radiation dose on survival of patients with limited-stage small-cell lung cancer.

Xia B, Chen GY, Cai XW, Zhao JD, Yang HJ, Fan M, Zhao KL, Fu XL - Radiat Oncol (2011)

Curves for overall survival (a) and progression-free survival (b). Comparison between biologically effective dose (BED) > 57 Gy and BED ≤ 57 Gy groups for patients with limited-stage small-cell lung cancer, both favouring the BED > 57G group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117707&req=5

Figure 1: Curves for overall survival (a) and progression-free survival (b). Comparison between biologically effective dose (BED) > 57 Gy and BED ≤ 57 Gy groups for patients with limited-stage small-cell lung cancer, both favouring the BED > 57G group.
Mentions: The median OS for patients treated with low BED and those with high BED were 16.4 months (95% CI, 10.9-21.9 months) and 25.4 months (95%CI, 21.9-29.0 months); 2- and 5-year OS were 31.5% and 14.6%, 55.2% and 26.2%, respectively (p = 0.005, Figure 1a). The probability of PFS was significantly higher in high BED group than in low BED group (p = 0.006, Figure 1b).

Bottom Line: Outcomes of the two groups were compared.Patients in high BED group had a significantly better local control (p = 0.024), progression-free survival (p = 0.006) and overall survival (p = 0.005), with a trend toward improved distant-metastasis free survival (p = 0.196).Multivariable Cox regression demonstrated that age (p = 0.003), KPS (p = 0.009), weight loss (p = 0.023), and BED (p = 0.004) were significant predictors of overall survival.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Centre, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

ABSTRACT

Background: To investigate the biological radiation dose-response for patients of limited-stage small-cell lung cancer (LS-SCLC) treated with high radiation dose.

Methods: Two hundred and five patients of LS-SCLC treated with sequential chemotherapy and thoracic radiotherapy with involved-field between 1997 and 2006 were reviewed retrospectively. Biologically effective dose (BED) was calculated for dose homogenization and was corrected with the factor of overall radiation time. Patients were divided into low BED group (n = 70) and high BED group (n = 135) with a cut-off of BED 57 Gy (equivalent to 60 Gy in 30 fractions over 40 days). Outcomes of the two groups were compared.

Results: Median follow-up was 20.7 months for all analyzable patients and 50.8 months for surviving patients. Considering all patients, median survival was 22.9 months (95% confidence interval, 20.6-25.2 months); 2- and 5-year survival rates were 47.2% and 22.3%, respectively. Patients in high BED group had a significantly better local control (p = 0.024), progression-free survival (p = 0.006) and overall survival (p = 0.005), with a trend toward improved distant-metastasis free survival (p = 0.196). Multivariable Cox regression demonstrated that age (p = 0.003), KPS (p = 0.009), weight loss (p = 0.023), and BED (p = 0.004) were significant predictors of overall survival.

Conclusions: Our data showed that a high BED was significantly associated with favourable outcomes in the Chinese LS-SCLC population, indicating that a positive BED-response relationship still existed even in a relatively high radiation dose range.

Show MeSH
Related in: MedlinePlus