A New Score for Estimating Survival After Definitive Radiochemotherapy of Limited Disease Small Cell Lung Cancers

Dirk Rades, Lukas Kaesmann, Stefan Janssen, Steven E. Schild

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Most patients with limited disease small cell lung cancer (LD-SCLC) receive definitive radiochemotherapy. Some patients cannot withstand combined modality treatments. Patients with short life expectancies should receive less time-consuming programs. For patients with favorable prognoses, cure while avoiding late toxicity is important. Personalized treatment programs are required. An instrument to estimate the survival after radiochemotherapy of LD-SCLC was created. Methods: Seventy-one patients receiving definitive radiochemotherapy for LD-SCLC were retrospectively analyzed. Eight factors were evaluated for survival including gender, age, Karnofsky performance score, T-stage, N-stage, tumor substage, number of pack years, and pre-radiotherapy hemoglobin level. Factors that were significant (p <0.05) or showed a trend (p ≤ 0.08) on multivariate analyses were incorporated in the score. Scoring points were derived from 2-year survival rates divided by 10 and added to scores for individual patients. Results: On multivariate analysis, gender (p = 0.03), performance score (p <0.001), and pre-radiotherapy hemoglobin level (p = 0.04) were significant, and tumor substage showed a trend (p = 0.08). Taking into account the 2-year survival rates of these factors, scores for single patients ranged from 9 to 26 points. Three groups were identified: 9–13, 14–18, and 19–26 points. One-year survival rates were 8, 73, and 100 %, respectively (p <0.001). Two-year survival rates were 0, 35, and 87 %, respectively (p <0.001). The 3-year survival rates were 0, 19, and 75 %, respectively (p <0.001). Conclusion: This score including three groups with significantly different survival rates is a helpful instrument for personalization of therapy for patients with LD-SCLC. When using this instrument, the limitations if this study must be taken into account.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalLung
DOIs
StateAccepted/In press - May 2 2016

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Small Cell Lung Carcinoma
Chemoradiotherapy
Survival
Survival Rate
Hemoglobins
Radiotherapy
Multivariate Analysis
Life Expectancy
Neoplasms
Therapeutics

Keywords

  • Definitive treatment
  • Prognostic score
  • Radiochemotherapy
  • Small cell lung cancer
  • Survival prognosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

A New Score for Estimating Survival After Definitive Radiochemotherapy of Limited Disease Small Cell Lung Cancers. / Rades, Dirk; Kaesmann, Lukas; Janssen, Stefan; Schild, Steven E.

In: Lung, 02.05.2016, p. 1-5.

Research output: Contribution to journalArticle

Rades, Dirk ; Kaesmann, Lukas ; Janssen, Stefan ; Schild, Steven E. / A New Score for Estimating Survival After Definitive Radiochemotherapy of Limited Disease Small Cell Lung Cancers. In: Lung. 2016 ; pp. 1-5.
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abstract = "Introduction: Most patients with limited disease small cell lung cancer (LD-SCLC) receive definitive radiochemotherapy. Some patients cannot withstand combined modality treatments. Patients with short life expectancies should receive less time-consuming programs. For patients with favorable prognoses, cure while avoiding late toxicity is important. Personalized treatment programs are required. An instrument to estimate the survival after radiochemotherapy of LD-SCLC was created. Methods: Seventy-one patients receiving definitive radiochemotherapy for LD-SCLC were retrospectively analyzed. Eight factors were evaluated for survival including gender, age, Karnofsky performance score, T-stage, N-stage, tumor substage, number of pack years, and pre-radiotherapy hemoglobin level. Factors that were significant (p <0.05) or showed a trend (p ≤ 0.08) on multivariate analyses were incorporated in the score. Scoring points were derived from 2-year survival rates divided by 10 and added to scores for individual patients. Results: On multivariate analysis, gender (p = 0.03), performance score (p <0.001), and pre-radiotherapy hemoglobin level (p = 0.04) were significant, and tumor substage showed a trend (p = 0.08). Taking into account the 2-year survival rates of these factors, scores for single patients ranged from 9 to 26 points. Three groups were identified: 9–13, 14–18, and 19–26 points. One-year survival rates were 8, 73, and 100 {\%}, respectively (p <0.001). Two-year survival rates were 0, 35, and 87 {\%}, respectively (p <0.001). The 3-year survival rates were 0, 19, and 75 {\%}, respectively (p <0.001). Conclusion: This score including three groups with significantly different survival rates is a helpful instrument for personalization of therapy for patients with LD-SCLC. When using this instrument, the limitations if this study must be taken into account.",
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AU - Rades, Dirk

AU - Kaesmann, Lukas

AU - Janssen, Stefan

AU - Schild, Steven E.

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N2 - Introduction: Most patients with limited disease small cell lung cancer (LD-SCLC) receive definitive radiochemotherapy. Some patients cannot withstand combined modality treatments. Patients with short life expectancies should receive less time-consuming programs. For patients with favorable prognoses, cure while avoiding late toxicity is important. Personalized treatment programs are required. An instrument to estimate the survival after radiochemotherapy of LD-SCLC was created. Methods: Seventy-one patients receiving definitive radiochemotherapy for LD-SCLC were retrospectively analyzed. Eight factors were evaluated for survival including gender, age, Karnofsky performance score, T-stage, N-stage, tumor substage, number of pack years, and pre-radiotherapy hemoglobin level. Factors that were significant (p <0.05) or showed a trend (p ≤ 0.08) on multivariate analyses were incorporated in the score. Scoring points were derived from 2-year survival rates divided by 10 and added to scores for individual patients. Results: On multivariate analysis, gender (p = 0.03), performance score (p <0.001), and pre-radiotherapy hemoglobin level (p = 0.04) were significant, and tumor substage showed a trend (p = 0.08). Taking into account the 2-year survival rates of these factors, scores for single patients ranged from 9 to 26 points. Three groups were identified: 9–13, 14–18, and 19–26 points. One-year survival rates were 8, 73, and 100 %, respectively (p <0.001). Two-year survival rates were 0, 35, and 87 %, respectively (p <0.001). The 3-year survival rates were 0, 19, and 75 %, respectively (p <0.001). Conclusion: This score including three groups with significantly different survival rates is a helpful instrument for personalization of therapy for patients with LD-SCLC. When using this instrument, the limitations if this study must be taken into account.

AB - Introduction: Most patients with limited disease small cell lung cancer (LD-SCLC) receive definitive radiochemotherapy. Some patients cannot withstand combined modality treatments. Patients with short life expectancies should receive less time-consuming programs. For patients with favorable prognoses, cure while avoiding late toxicity is important. Personalized treatment programs are required. An instrument to estimate the survival after radiochemotherapy of LD-SCLC was created. Methods: Seventy-one patients receiving definitive radiochemotherapy for LD-SCLC were retrospectively analyzed. Eight factors were evaluated for survival including gender, age, Karnofsky performance score, T-stage, N-stage, tumor substage, number of pack years, and pre-radiotherapy hemoglobin level. Factors that were significant (p <0.05) or showed a trend (p ≤ 0.08) on multivariate analyses were incorporated in the score. Scoring points were derived from 2-year survival rates divided by 10 and added to scores for individual patients. Results: On multivariate analysis, gender (p = 0.03), performance score (p <0.001), and pre-radiotherapy hemoglobin level (p = 0.04) were significant, and tumor substage showed a trend (p = 0.08). Taking into account the 2-year survival rates of these factors, scores for single patients ranged from 9 to 26 points. Three groups were identified: 9–13, 14–18, and 19–26 points. One-year survival rates were 8, 73, and 100 %, respectively (p <0.001). Two-year survival rates were 0, 35, and 87 %, respectively (p <0.001). The 3-year survival rates were 0, 19, and 75 %, respectively (p <0.001). Conclusion: This score including three groups with significantly different survival rates is a helpful instrument for personalization of therapy for patients with LD-SCLC. When using this instrument, the limitations if this study must be taken into account.

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KW - Prognostic score

KW - Radiochemotherapy

KW - Small cell lung cancer

KW - Survival prognosis

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