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document
[ A prospective randomized study of the radiotherapy volume for limited-stage small cell lung cancer : a preliminary report ] . BACKGROUND AND OBJECTIVE Controversies exists with regard to target volumes as far as thoracic radiotherapy ( TRT ) is concerned in the multimodality treatment for limited-stage small cell lung cancer ( LSCLC ) . The aim of this study is to prospectively compare the local control rate , toxicity profiles , and overall survival ( OS ) between patients received different target volumes irradiation after induction chemotherapy . METHODS LSCLC patients received 2 cycles of etoposide and cisplatin ( EP ) induction chemotherapy and were randomly assigned to receive TRT to either the post- or pre-chemotherapy tumor extent ( GTV-T ) as study arm and control arm , CTV-N included the positive nodal drainage area for both arms . One to 2 weeks after induction chemotherapy , 45 Gy/30 Fx/19 d TRT was administered concurrently with the third cycle of EP regimen . After that , additional 3 cycles of EP consolidation were administered . Prophylactic cranial irradiation ( PCI ) was administered to patients with a complete response . RESULTS Thirty-seven and 40 patients were randomly assigned to study arm and control arm . The local recurrence rates were 32.4 % and 28.2 % respectively ( P = 0.80 ) ; the isolated nodal failure ( INF ) rates were 3.0 % and 2.6 % respectively ( P = 0.91 ) ; all INF sites were in the ipsilateral supraclavicular fossa . Medastinal N3 disease was the risk factor for INF ( P = 0.02 , OR = 14.13 , 95 % CI : 1.47-136.13 ) . During radiotherapy , grade I , II weight loss was observed in 29.4 % , 5.9 % and 56.4 % , 7.7 % patients respectively ( P = 0.04 ) . Grade 0-I and II-III late pulmonary injury was developed in 97.1 % , 2.9 % and 86.4 % , 15.4 % patients respectively ( P = 0.07 ) . Median survival time was 22.1 months and 26.9 months respectively . The 1 to 3-year OS were 77.9 % , 44.4 % , 37.3 % and 75.8 % , 56.3 % , 41.7 % respectively ( P = 0.79 ) . CONCLUSIONS The preliminary results of this study indicate that irradiant the post-chemotherapy tumor extent ( GTV-T ) and positive nodal drainage area did not decrease local control and overall survival while radiation toxicity was reduced . But the current sample size has not met designed requirements , and further investigation is warranted before final conclusions could be drawn .
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Intervention_Physical
radiotherapy volume
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Intervention_Physical
thoracic radiotherapy ( TRT )
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Intervention_Pharmacological
induction chemotherapy
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Intervention_Pharmacological
etoposide and cisplatin ( EP ) induction chemotherapy
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Intervention_Physical
TRT
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Intervention_Pharmacological
induction chemotherapy
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Intervention_Physical
45 Gy/30 Fx/19 d TRT
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Intervention_Pharmacological
EP regimen
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Intervention_Pharmacological
EP
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Intervention_Physical
Prophylactic cranial irradiation ( PCI )
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Outcome_Physical
local recurrence rates
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Outcome_Physical
nodal failure ( INF )
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Outcome_Physical
Medastinal N3 disease
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Outcome_Physical
grade I , II weight loss
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Outcome_Physical
Grade 0-I and II-III late pulmonary injury
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Outcome_Mortality
Median survival time
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Outcome_Mortality
1 to 3-year OS
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Participant_Condition
limited-stage small cell lung cancer
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Participant_Condition
LSCLC
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Participant_Condition
LSCLC patients
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Participant_Sample-size
Thirty-seven
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Participant_Sample-size
40