Population-based Results of Chemoradiotherapy for Limited Stage Small Cell Lung Cancer in The Netherlands

R. Damhuis*, J. Widder, S. Senan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Aims: Treatment guidelines for limited stage small cell lung cancer (LS-SCLC) favour early concurrent chemoradiotherapy (CRT). Little is known about contemporary, real-world treatment patterns and outcome. We evaluated population-based practice patterns of CRT and corresponding survival in the Netherlands, focusing on the impact of the 2011 national guidelines recommending use of twice-daily (BID) radiotherapy, and treatment outcomes in elderly patients.

Materials and methods: Data for 1635 patients with LS-SCLC treated with CRT from 2010 to 2014 were retrieved from the Netherlands Cancer Registry. The type of CRT was designated as either concurrent BID, concurrent once-daily (OD), concurrent atypical or sequential. Overall survival was the primary end point and prognostic factors were evaluated with multivariable Cox regression and represented by hazard ratios and 95% confidence intervals.

Results: The most common form of CRT used was sequential (41%). The proportion of patients treated BID increased from 13% in 2010-2011 to 36% in 2013-2014 (P <0.001). The median survival was 21 months and did not improve with time (P = 0.58). Five year survival was 16% for sequential, 31% for BID (hazard ratio = 0.67, confidence interval 0.57-0.79) and 28% for OD (hazard ratio = 0.73, confidence interval 0.63-0.85). In patients aged 70 years and older, concurrent CRT was less often used than in younger patients (45% versus 66%) and 5 year survival after concurrent CRT was less favourable; 18% versus 32%, respectively.

Conclusions: Outcome data at the population level for LS-SCLC are equivalent to those reported in clinical trials. The increased use of BID schemes since 2011 did not improve survival.

Original languageEnglish
Pages (from-to)17-22
Number of pages6
JournalClinical Oncology
Volume30
Issue number1
DOIs
Publication statusPublished - Jan-2018

Keywords

  • Chemoradiotherapy
  • concurrent
  • elderly
  • patterns of care
  • small cell lung cancer
  • survival
  • THORACIC RADIOTHERAPY
  • CONCURRENT CHEMORADIATION
  • MANAGEMENT
  • ONCOLOGISTS
  • SURVIVAL
  • TRIAL

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