Chemoradiotherapy Outcomes Associated With Stage of Small Cell Lung Cancer
Secondary analysis of data compared chemoradiotherapy outcomes in stage I-II vs stage III disease.
A study examined features and chemoradiotherapy outcomes for patients with early-stage small cell lung cancer (SCLC), with results published in JAMA Oncology.
The study was a secondary analysis of data from the phase 3 Concurrent Once-Daily vs Twice-Daily Radiotherapy Trial (CONVERT) of patients with SCLC.
Patients were randomized 1:1 to 2 treatment arms — treatment once per day vs twice per day — in which most patients received radiotherapy concurrently with chemotherapy. This analysis evaluated overall survival (OS) by disease stage, with patients grouped by stage I-II disease (n=86) or stage III disease (n=423).
Gross tumor volume was significantly larger for patients with stage III disease than with stage I-II disease (P < .001), but reported patient and treatment characteristics were not otherwise significantly different between stage I-II and stage III.
Stage III disease was associated with a shorter median OS (25 months; 95% CI, 21-29 months) than was stage I-II disease (50 months; 95% CI, 38 months to not reached; hazard ratio vs stage III, 0.60; 95% CI, 0.44-0.83; P = .001). Five-year OS was 28% (95% CI, 23%-34%) for stage III disease and 49% (95% CI, 39%-62%) for stage I-II disease.
Treatment did not confer a statistically significant difference in OS for patients with stage I-II SCLC, and radiologic tumor response was not significantly different between stage I-II and stage III groups.
Patients with stage I-II disease showed relatively less acute esophagitis than did patients with stage III disease (P < .001), but otherwise reported adverse events did not significantly differ by stage.
In this study, stage I-II SCLC was associated with higher rates of survival with chemoradiotherapy than was stage III disease.
Salem A, Mistry H, Hatton M, et al. Association of chemoradiotherapy with outcomes among patients with stage I to II vs stage III small cell lung cancer: secondary analysis of a randomized clinical trial [published online December 6, 2018]. JAMA Oncol. doi: 10.1001/jamaoncol.2018.5335