TITLE:
Accelerated Hypofractionated Radiotherapy and Concurrent Etoposide/Cisplatin in Patients with Limited-Disease SCLC (LD-SCLC)
AUTHORS:
Wessam Elghamry, Ali Azmy, Iman Fouad, Zeinab Elsayed, Sherif Abdelwahab
KEYWORDS:
LD-SCLC, Etoposide, Cisplatin, Accelerated Radiation Therapy
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.11 No.11,
November
18,
2020
ABSTRACT: Background:The optimal TRT dose/fraction for LD-SCLC remains
debatable, and due to increasing number of population in Egypt and number of
patients as well, so reducing the duration of radiation therapy is favored.
This study was conducted using etoposide and cisplatin (EP) concurrently with
accelerated hypofractionated TRT to evaluate the response and toxicity of this
protocol in the treatment of patients with limited-disease small cell lung
cancer (LD-SCLC). Patients and Methods: Thirty patients with previously untreated LD-SCLC
were enrolled into this study between June 2012 and February 2015. All patients
received etoposide 100 mg/m2 days 1 to 3 and cisplatin 25 mg/m2 days 1 to 3 with start of accelerated hypofractionated thoracic radiation
therapy on first day of the second cycle of chemotherapy of 55 Gy, 2.5 Gy/fraction
over 30 days. Chemotherapy was given 4 - 6
cycles. Prophylactic cranial irradiation 25 Gy/10 fractions were given for patients who achieved complete remission. Results: The median age was 60 years; 28 patients (93%) were
men. ECOG PS was 0 in 5 (17%) patients and 1 in 12 (40%) patients. Four (13%)
patients achieved a complete response (CR), 17 (57%) patients achieved a
partial response (PR), while 7 patients (23%) had progressive disease (PD), and the ORR was 90%. The median survival time was 26.4 months. The median PFS
was 16.7 months. Among the hematologic toxicities neutropenia was the most
prevalent toxicity and it was evident as grade 3 - 4 in 12
(40%) patients. Grade 3 - 4 Asthenia was the most prevalent nonhematological toxicity, in 12 (40%)
patients; esophagitis occurred in 7 (23%) patients. No treatment-related deaths
(due to sepsis or bleeding) were reported in the study. Conclusion: Using etoposide and cisplatin concurrently with
accelerated hypofractionated thoracic radiation therapy for the treatment of
patients with LD-SCLC showed an encouraging outcome and acceptable toxicity and
warrants further research.