M Fiegl1, A Pircher2, C Waldthaler2, G Gamerith2, F Kocher2, G Pall2, M Nevinny3, T Schmid4, W Sterlacci5, H Jamnig6, G Zangerl7, A Zabernigg8, W Oberaigner9, W Hilbe2. 1. Department of Internal Medicine V, Hemato-Oncology, Medical University of Innsbruck, Innsbruck, Austria. Electronic address: michael.fiegl@i-med.ac.at. 2. Department of Internal Medicine V, Hemato-Oncology, Medical University of Innsbruck, Innsbruck, Austria. 3. Department of Radiooncology, Medical University of Innsbruck, Innsbruck, Austria. 4. Department of Surgery, Medical University of Innsbruck, Innsbruck, Austria. 5. Department of Pathology, Medical University of Innsbruck, Innsbruck, Austria. 6. Department of Pneumology, Academic Natters Hospital, Natters, Austria. 7. Department of Internal Medicine, Hospital of Zams, Zams, Austria. 8. Department of Internal Medicine, Hospital of Kufstein, Kufstein, Austria. 9. Department of Clinical Epidemiology (IET), Innsbruck, Austria.
Abstract
BACKGROUND: It is not clear whether or not the fate of patients suffering from small-cell lung cancer (SCLC) has improved. To better understand the course of disease, we aimed at documenting disease features at initial diagnosis, sequences of therapy modalities and outcome in consecutive patients over two decades. We postulated that SCLC patients might have benefitted from refined diagnosis and treatment options during the last decade. METHODS: All SCLC cases diagnosed at the Innsbruck University Hospital and associated institutions between 1991 and 2011 have been documented in detail in accordance with a prespecified protocol. RESULTS: A total of 484 patients diagnosed with SCLC were followed. The most important symptoms at initial diagnosis were cough, dyspnea and tumor pain in 55%, 51% and 44%, respectively. Patients who were operated during early stage of disease (n = 26) had a favorable 5-year, relapse-free survival (74%). A total of 112 patients with locally advanced disease were treated by radiochemotherapy in curative intent (RCT), and achievement of CR offered a chance of long term overall survival (OS), reaching 44% after 10-years. In the palliative setting (median OS in 304 evaluable patients, 9.7 months), a therapeutic progress in the more recent decade could not be observed. Parameters independently associated with favorable OS were: response to therapy and prophylactic brain irradiation in patients with RCT; and response, age < 70 years and absence of LDH elevation in the palliative setting. CONCLUSIONS: In this comprehensive view on SCLC, the findings on symptomatology, comorbidity, and spectrum of treatments may help to better understand individual courses of the disease. Overall, modern medicine failed to translate into substantial benefit of SCLC patients, except in patients in locally advanced disease receiving multimodal therapy.
BACKGROUND: It is not clear whether or not the fate of patients suffering from small-cell lung cancer (SCLC) has improved. To better understand the course of disease, we aimed at documenting disease features at initial diagnosis, sequences of therapy modalities and outcome in consecutive patients over two decades. We postulated that SCLCpatients might have benefitted from refined diagnosis and treatment options during the last decade. METHODS: All SCLC cases diagnosed at the Innsbruck University Hospital and associated institutions between 1991 and 2011 have been documented in detail in accordance with a prespecified protocol. RESULTS: A total of 484 patients diagnosed with SCLC were followed. The most important symptoms at initial diagnosis were cough, dyspnea and tumor pain in 55%, 51% and 44%, respectively. Patients who were operated during early stage of disease (n = 26) had a favorable 5-year, relapse-free survival (74%). A total of 112 patients with locally advanced disease were treated by radiochemotherapy in curative intent (RCT), and achievement of CR offered a chance of long term overall survival (OS), reaching 44% after 10-years. In the palliative setting (median OS in 304 evaluable patients, 9.7 months), a therapeutic progress in the more recent decade could not be observed. Parameters independently associated with favorable OS were: response to therapy and prophylactic brain irradiation in patients with RCT; and response, age < 70 years and absence of LDH elevation in the palliative setting. CONCLUSIONS: In this comprehensive view on SCLC, the findings on symptomatology, comorbidity, and spectrum of treatments may help to better understand individual courses of the disease. Overall, modern medicine failed to translate into substantial benefit of SCLCpatients, except in patients in locally advanced disease receiving multimodal therapy.
Authors: Rui Liu; Shu Lin He; Yuan Chen Zhao; Hong Gang Zheng; Cong Huang Li; Yan Ju Bao; Ying Gang Qin; Wei Hou; Bao Jin Hua Journal: Evid Based Complement Alternat Med Date: 2015-03-01 Impact factor: 2.629
Authors: Lei Deng; ZongMei Zhou; ZeFen Xiao; DongFu Chen; QinFu Feng; Jun Liang; JiMa Lv; XiaoZhen Wang; Nan Bi; Xin Wang; Tao Zhang; WenQing Wang; LvHua Wang Journal: Thorac Cancer Date: 2019-02-18 Impact factor: 3.500